Individual provider Active NPI

Kellen Ann Pickard, L.AC

  • Acupuncturist
  • San Diego, CA
National Provider Identifier
1316249451
Registry record updated Jul 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC13929 Issued in CA
Practice address
4747 Mission Blvd Ste 7
San Diego, CA 92109-2541
Phone
(858) 581-2887
NPI assigned
Nov 22, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC13929 CA Primary

Addresses

Primary practice location

4747 Mission Blvd Ste 7
San Diego, CA 92109-2541

Mailing address

2277 Caminito Pescado Unit 74
San Diego, CA 92107-1916
Phone (775) 232-7256

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

LicenseStateTypeSpecialty
AC13929CAMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1290384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310342400000",
    "number": "1316249451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2277 CAMINITO PESCADO UNIT 74",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921071916",
            "telephone_number": "775-232-7256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4747 MISSION BLVD STE 7",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921092541",
            "telephone_number": "858-581-2887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PICKARD",
        "first_name": "KELLEN",
        "middle_name": "ANN",
        "name_prefix": "Miss",
        "credential": "L.AC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-11-22",
        "last_updated": "2011-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC13929",
            "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 Jul 11, 2011; 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.