Individual provider Active NPI

Carlyn Marie Montes de Oca, LAC

  • Acupuncturist
  • San Anselmo, CA
National Provider Identifier
1356866396
Registry record updated Aug 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC10021 Issued in CA
Practice address
130 Greenfield Ave
San Anselmo, CA 94960-2449
Phone
(415) 306-1853
Fax
(415) 306-1853
NPI assigned
Aug 10, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 10, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC10021 CA Primary

Addresses

Primary practice location

130 Greenfield Ave
San Anselmo, CA 94960-2449

Mailing address

PO Box 312
Forest Knolls, CA 94933-0312
Phone (415) 306-1853

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
AC10021CAMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1502323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1502323200000",
    "number": "1356866396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 312",
            "city": "FOREST KNOLLS",
            "state": "CA",
            "postal_code": "949330312",
            "telephone_number": "415-306-1853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 GREENFIELD AVE",
            "city": "SAN ANSELMO",
            "state": "CA",
            "postal_code": "949602449",
            "telephone_number": "415-306-1853",
            "fax_number": "415-306-1853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTES DE OCA",
        "first_name": "CARLYN",
        "middle_name": "MARIE",
        "credential": "LAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-10",
        "last_updated": "2017-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC10021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Anselmo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2017; 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.