Individual provider Active NPI

Desiree Marie-Belle Paus, L.AC, HHP, MS, AS

  • Acupuncturist
  • San Diego, CA
National Provider Identifier
1306017363
Registry record updated Apr 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC11330 Issued in CA
Practice address
4632 Oregon St
# 5
San Diego, CA 92116-6006
Phone
(619) 518-8740
Fax
(619) 255-8727
NPI assigned
Mar 18, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC11330 CA Primary

Addresses

Primary practice location

4632 Oregon St
# 5
San Diego, CA 92116-6006

Mailing address

4632 Oregon St Apt 5
San Diego, CA 92116-6007
Phone (619) 518-8740

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
Credentials
Associate of Science, Master of Science

State licenses

LicenseStateTypeSpecialty
AC11330CAMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1205798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713744000000",
    "number": "1306017363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4632 OREGON ST APT 5",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921166007",
            "telephone_number": "619-518-8740",
            "fax_number": "619-255-8727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4632 OREGON ST",
            "address_2": "# 5",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921166006",
            "telephone_number": "619-518-8740",
            "fax_number": "619-255-8727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAUS",
        "first_name": "DESIREE",
        "middle_name": "MARIE-BELLE",
        "name_prefix": "Ms.",
        "credential": "L.AC, HHP, MS, AS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-18",
        "last_updated": "2024-04-22",
        "certification_date": "2024-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC11330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2024; 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.