Jennifer Dong, MS, L.AC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1200079 Issued in CA

Practice address

1227 Buena Vista St Ste F
Duarte, CA 91010-2486

Phone

(877) 254-4496

NPI assigned

Dec 12, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science, Physician Assistant

State licenses

Practice roles

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Family Community Acupuncture

  • Acupuncturist
  • Pacifica, CA
  • NPI 1912246679
  NPD (past)

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

{
    "created_epoch": "1513036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675296000000",
    "number": "1215442207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 S LARK ELLEN AVE APT 55",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917921136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1227 BUENA VISTA ST STE F",
            "city": "DUARTE",
            "state": "CA",
            "postal_code": "910102486",
            "telephone_number": "877-254-4496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONG",
        "first_name": "JENNIFER",
        "credential": "MS, L.AC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-12",
        "last_updated": "2023-02-02",
        "certification_date": "2023-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC17606",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "1200079",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "62155",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ariane Djeussoung, DNP
• Thao X. DO, M.D.
• Thanh Nga Thi Doan, M.D.
• Jonas Preston Doanman, PA-C
• Michael Donahue, MD
• Jiali Dong
• Amy E S Donner, LCSW
• Jeremiah Paul Donovan, MD
• Tanya B Dorff, M.D.
• Ashley A. Dorn, N.P.

• Physician Assistant in Duarte, CA
• Providers in Duarte, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2023; 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.