Raven Acupuncture Clinic, Inc.

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

16969 Issued in CA

Legal business name

RAVEN ACUPUNCTURE CLINIC, INC.

Practice address

1961 Pruneridge Ave
Suite B1
Santa Clara, CA 95050-6575

Phone

(408) 758-2881

Fax

(855) 781-8279

NPI assigned

Jul 24, 2016

Organization subpart

No

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

Authorized official

Name

Jocelyn Chie Jackson, L.AC.

Title

President

Phone

(408) 758-2881

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1469318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471996800000",
    "number": "1306399563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1961 PRUNERIDGE AVE",
            "address_2": "SUITE B1",
            "city": "SANTA CLARA",
            "state": "CA",
            "postal_code": "950506575",
            "telephone_number": "408-758-2881",
            "fax_number": "855-781-8279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1961 PRUNERIDGE AVE",
            "address_2": "SUITE B1",
            "city": "SANTA CLARA",
            "state": "CA",
            "postal_code": "950506575",
            "telephone_number": "408-758-2881",
            "fax_number": "855-781-8279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAVEN ACUPUNCTURE CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-24",
        "last_updated": "2016-08-24",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "JOCELYN",
        "authorized_official_middle_name": "CHIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "408-758-2881",
        "authorized_official_credential": "L.AC."
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "16969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimini Randall
• Archana Rao, MD
• Bensy Raphy
• Jyoti Rau, M.D.,PH.D.
• Nishita Parag Raut
• Chandni Vaid Ravi, MD
• Sumayyah Rawashdeh
• Reija Matheson Rawle, M.D.
• Deborah A. Ray, MD
• Pratikshya Ray

• Acupuncturist in Santa Clara, CA
• Providers in Santa Clara, CA by specialty
• Acupuncturist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2016; 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.