Isa Ingram, L.AC.

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

AC 12674 Issued in CA

Practice address

4150 V St Ste 1200
Sacramento, CA 95817-1460

Phone

(916) 413-6625

NPI assigned

Mar 23, 2011

Reactivated

Apr 7, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Christine Gocke Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1300838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657238400000",
    "number": "1316246820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3940 H ST APT 207",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958192759",
            "telephone_number": "916-413-6625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4150 V ST STE 1200",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958171460",
            "telephone_number": "916-413-6625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INGRAM",
        "first_name": "ISA",
        "credential": "L.AC.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-23",
        "last_updated": "2022-07-08",
        "certification_date": "2022-07-08",
        "deactivation_date": "2019-08-14",
        "reactivation_date": "2021-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC 12674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTINE",
            "last_name": "GOCKE",
            "credential": "L.AC.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Betty Ingell, ED.D., FNP, PA-C
• Cassandra Renee Ingemansson, FNP
• Christina Ingle
• Ambercelia Ingram
• Drew Christian Ingram, M.D.
• Kate Ingram, MPH
• Kenisha Rose Ingram
• Lewis E. Ingram, FNP
• Michael T Ingram, MD
• Samantha Ingram, B.A.E

• Acupuncturist in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Acupuncturist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2022; 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.