Tina Yan Li, PHD

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

AC 15336 Issued in CA

Practice address

22711 Canyon Lake Dr N
Canyon Lake, CA 92587-8014

Phone

(909) 997-9966

NPI assigned

Jun 12, 2013

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

Credentials

Doctor of Philosophy

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.

• PCC Acupuncture Group

  • Acupuncturist
  • Canyon Lake, CA
  • NPI 1447001300
  NPD Authorized official

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

{
    "created_epoch": "1370995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370995200000",
    "number": "1245678275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22711 CANYON LAKE DR N",
            "city": "CANYON LAKE",
            "state": "CA",
            "postal_code": "925878014",
            "telephone_number": "909-997-9966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22711 CANYON LAKE DR N",
            "city": "CANYON LAKE",
            "state": "CA",
            "postal_code": "925878014",
            "telephone_number": "909-997-9966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LI",
        "first_name": "TINA YAN",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-12",
        "last_updated": "2013-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC 15336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maureen Amie Allen Kaczmarski, MFCT
• Nicole Ladson Dubose
• Geena Lee
• Ku Il Lee, D.C.
• Jennifer D Lewis, CMT
• Donica Alexa Loney, PA
• Margaret Marilla, BCBA
• Taylor Rose Martin
• Mary L. Demoss O.D. Inc.
• Mason Dental Hygiene Group

• Acupuncturist in Canyon Lake, CA
• Providers in Canyon Lake, CA by specialty
• Acupuncturist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2013; 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.