Roberta Anne Daugherty, L.AC., MSTOM, BA

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

AC12060 Issued in CA

Practice address

9820 Willow Creek Rd
Suite #485
San Diego, CA 92131-1112

Phone

(858) 689-2279

Fax

(858) 689-2274

NPI assigned

Feb 5, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Arts

State licenses

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

{
    "created_epoch": "1233792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233792000000",
    "number": "1407095045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9820 WILLOW CREEK RD",
            "address_2": "SUITE #485",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921311112",
            "telephone_number": "858-689-2279",
            "fax_number": "858-689-2274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9820 WILLOW CREEK RD",
            "address_2": "SUITE #485",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921311112",
            "telephone_number": "858-689-2279",
            "fax_number": "858-689-2274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAUGHERTY",
        "first_name": "ROBERTA",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "L.AC., MSTOM, BA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-02-05",
        "last_updated": "2009-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC12060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Daub
• Jenessa Pascoe Daugherty, MA
• Justin Benton Daugherty, IDC
• Mia Anjolique Daugherty
• Natasha Mae Daugherty
• Jason D Daughety, D.O., M.P.H
• Riyasha Daulat, MD
• Janice I. Daulton, R.D.
• Rachel Mary Dauod
• Patricia Dauphin

• Acupuncturist in San Diego, CA
• Providers in San Diego, CA by specialty
• Acupuncturist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2009; 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.