Individual provider Active NPI

Soo Jin Cho, LAC

  • Acupuncturist
  • Anaheim, CA
National Provider Identifier
1205347069
Registry record updated Feb 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC17641 Issued in CA
Practice address
520 N Brookhurst St Ste 204
Anaheim, CA 92801-5236
Phone
(714) 443-1779
NPI assigned
Oct 19, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC17641 CA Primary

Addresses

Primary practice location

520 N Brookhurst St Ste 204
Anaheim, CA 92801-5236

Mailing address

1000 N Roanne PL # B
Anaheim, CA 92801-3206
Phone (714) 443-1779

Other identifiers 1

IdentifierTypeStateIssuer
4284443MedicaidCA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address infeo@life-and-nature.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AC17641CAMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Life and Nature Wellness Inc Acupuncturist CurrentSince Oct 12, 2025 Accepting new patients
Life and Nature Wellness Inc Acupuncturist CurrentSince Aug 25, 2025 Accepting new patients

Locations

520 N Brookhurst St
Ste 204
Anaheim, CA 92801
Phone (714) 443-1779

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1508371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739923200000",
    "number": "1205347069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 N ROANNE PL # B",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928013206",
            "telephone_number": "714-443-1779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 N BROOKHURST ST STE 204",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928015236",
            "telephone_number": "714-443-1779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHO",
        "first_name": "SOO JIN",
        "credential": "LAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-19",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC17641",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4284443",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "infeo@life-and-nature.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "520 N Brookhurst St Ste 204",
            "city": "Anaheim",
            "state": "CA",
            "country_code": "US",
            "postal_code": "928015236",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2025; 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.