Active NPI
Stephanie X Gong, LAC
- Acupuncturist
- Livermore, CA
National Provider Identifier
1346734001
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 18004
- Practice address
- 4080 East Ave
Livermore, CA 94550-4941 - Phone
- (925) 606-6013
- NPI assigned
- Jun 17, 2018
- 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 | 18004 | CA | Primary |
Addresses
Primary practice location
4080 East Ave
Livermore, CA 94550-4941
Mailing address
6276 Camino del Lago
Pleasanton, CA 94566-8647
Phone (925) 895-8395
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 |
|---|---|---|---|
| 18004 | CA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1529193600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1529193600000",
"number": "1346734001",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6276 CAMINO DEL LAGO",
"city": "PLEASANTON",
"state": "CA",
"postal_code": "945668647",
"telephone_number": "925-895-8395"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4080 EAST AVE",
"city": "LIVERMORE",
"state": "CA",
"postal_code": "945504941",
"telephone_number": "925-606-6013"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONG",
"first_name": "STEPHANIE",
"middle_name": "X",
"credential": "LAC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-06-17",
"last_updated": "2018-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "CA",
"license": "18004",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Livermore, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.