Active NPI
Jennifer Kei Kehaulani Leialoha Lane, MSTOM, HHP, L. AC.
- Acupuncturist
- Mammoth Lakes, CA
National Provider Identifier
1265587315
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- AC 11205
- Practice address
- 452 Old Mammoth Road
Mammoth Lakes, CA 93546 - Phone
- (760) 934-7438
- NPI assigned
- Jan 25, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | AC 11205 | CA | Primary |
Addresses
Primary practice location
452 Old Mammoth Road
Mammoth Lakes, CA 93546
Mailing address
Post Office Box 9274
Mammoth Lakes, CA 93546
Phone (760) 934-9659
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AC 11205 | CA | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169683200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1265587315",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "POST OFFICE BOX 9274",
"city": "MAMMOTH LAKES",
"state": "CA",
"postal_code": "93546",
"telephone_number": "760-934-9659"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "452 OLD MAMMOTH ROAD",
"city": "MAMMOTH LAKES",
"state": "CA",
"postal_code": "93546",
"telephone_number": "760-934-7438"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEIALOHA LANE",
"first_name": "JENNIFER",
"middle_name": "KEI KEHAULANI",
"name_prefix": "Mrs.",
"credential": "MSTOM, HHP, L. AC.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "CA",
"license": "AC 11205",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mammoth Lakes, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.