Individual provider Active NPI

Rose Ann Larsen, L.AC.

  • Acupuncturist
  • Newport Beach, CA
National Provider Identifier
1366563538
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC4579 Issued in CA
Practice address
4029 Westerly PL
Suite 110
Newport Beach, CA 92660-2318
Phone
(949) 251-1109
Fax
(949) 475-0165
NPI assigned
Apr 3, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC4579 CA Primary

Addresses

Primary practice location

4029 Westerly PL
Suite 110
Newport Beach, CA 92660-2318

Mailing address

4029 Westerly PL
Suite 110
Newport Beach, CA 92660-2318
Phone (949) 251-1109

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
AC4579CAMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366563538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4029 WESTERLY PL",
            "address_2": "SUITE 110",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926602318",
            "telephone_number": "949-251-1109",
            "fax_number": "949-475-0165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4029 WESTERLY PL",
            "address_2": "SUITE 110",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926602318",
            "telephone_number": "949-251-1109",
            "fax_number": "949-475-0165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSEN",
        "first_name": "ROSE",
        "middle_name": "ANN",
        "credential": "L.AC.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC4579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.