Elixir Lifestyle Medicine

Primary specialty

AcupuncturistTaxonomy code 171100000X

Legal business name

ELIXIR LIFESTYLE MEDICINE

Practice address

1732 Palma Dr Ste 104
Ventura, CA 93003-5796

Phone

(805) 644-1064

Fax

(805) 642-6524

NPI assigned

Sep 5, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Stace Nelson-Hicks, DACM, L.AC. , CFMP

Title

Chief Executive Officer

Phone

(805) 644-1064

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1567641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1567641600000",
    "number": "1194374884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1732 PALMA DR STE 104",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930035796",
            "telephone_number": "805-644-1064",
            "fax_number": "805-642-6524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1732 PALMA DR STE 104",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930035796",
            "telephone_number": "805-644-1064",
            "fax_number": "805-642-6524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELIXIR LIFESTYLE MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-05",
        "last_updated": "2019-09-05",
        "status": "A",
        "authorized_official_last_name": "NELSON-HICKS",
        "authorized_official_first_name": "STACE",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "805-644-1064",
        "authorized_official_credential": "DACM, L.AC. , CFMP"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Majid Elalami, DO
• Winchell Rivera Elbo, AGPCNP-BC
• Swati Vijaylakshmi Elchuri, M.D.
• Adam Eliav
• Susan Eligado, RN
• Joseph David Elkins
• Graham James Ellis, DO
• Larry Edward Ellis, RADT
• Azadeh Ellsworth, PMHNP
• Heidi Michelle Elowitch, PHD

• Acupuncturist in Ventura, CA
• Providers in Ventura, CA by specialty
• Acupuncturist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.