Individual provider Active NPI

Jacy Maria Davis, LAC

  • Acupuncturist
  • Pasadena, CA
National Provider Identifier
1376008359
Registry record updated Aug 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
18386 Issued in CA
Practice address
117 W Bellevue Dr Ste 1
Pasadena, CA 91105-2548
Phone
(323) 762-6520
NPI assigned
Feb 4, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 18386 CA Primary

Addresses

Primary practice location

117 W Bellevue Dr Ste 1
Pasadena, CA 91105-2548

Mailing address

4312 Gateway Ave
Los Angeles, CA 90029-2120
Phone (323) 762-6520

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
18386CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Cedars-Sinai Medical Care Foundation Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1549238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565740800000",
    "number": "1376008359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4312 GATEWAY AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900292120",
            "telephone_number": "323-762-6520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 W BELLEVUE DR STE 1",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911052548",
            "telephone_number": "323-762-6520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JACY",
        "middle_name": "MARIA",
        "credential": "LAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-04",
        "last_updated": "2019-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "18386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2019; 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.