Roya Nematollahi, LAC

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

AC-386 Issued in ID

Practice address

1012 12TH Ave S
Nampa, ID 83651-4661

Phone

(208) 999-0793

Fax

(208) 475-3091

NPI assigned

May 22, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745884800000",
    "number": "1396955241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17263 W LINDEN ST",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836079209",
            "telephone_number": "208-999-0793",
            "fax_number": "208-475-3091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1012 12TH AVE S",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836514661",
            "telephone_number": "208-999-0793",
            "fax_number": "208-475-3091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEMATOLLAHI",
        "first_name": "ROYA",
        "name_prefix": "Ms.",
        "credential": "LAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-22",
        "last_updated": "2025-04-29",
        "certification_date": "2025-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC6100",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "ID",
            "license": "AC-386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Acupuncturist in Nampa, ID
• Providers in Nampa, ID by specialty
• Acupuncturist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2025; 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.