Kelly Clohessy, LAC

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

158883 Issued in CA

Practice address

101 Lucas Valley Rd # 317
San Rafael, CA 94903-1791

Phone

(650) 222-4066

NPI assigned

Dec 14, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Visionary Healthcare

  • Health Maintenance Organization
  • San Rafael, CA
  • NPI 1699422535
  NPD Authorized official

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

{
    "created_epoch": "1607904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607904000000",
    "number": "1205422284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 LUCAS VALLEY RD # 317",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949031791",
            "telephone_number": "650-222-4066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 LUCAS VALLEY RD # 317",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949031791",
            "telephone_number": "650-222-4066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLOHESSY",
        "first_name": "KELLY",
        "credential": "LAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-14",
        "last_updated": "2020-12-14",
        "certification_date": "2020-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "158883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tammy Swahn Cleland
• Stacey Nelson Clemenceau, PH.D.
• Cheryl Clementson
• Tiffany Ann Cleveland
• Jean Clinton, LPC
• Gina Noelle Cloney, NP
• John L Clothier, M.D.
• Jessica Anne Clubb, PHARM.D.
• Lynne Clyde, LMFT, #104574
• Reed Coast, DPM

• Acupuncturist in San Rafael, CA
• Providers in San Rafael, CA by specialty
• Acupuncturist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2020; 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.