Active NPI
Marisa Puente, DACM, L.AC.
- Acupuncturist
- San Clemente, CA
National Provider Identifier
1457941635
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 19026
- Practice address
- 147 Avenida Serra Apt 207
San Clemente, CA 92672-4741 - Phone
- (619) 818-2510
- NPI assigned
- Jan 21, 2021
- Last updated
- Jan 21, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | 19026 | CA | Primary |
Addresses
Primary practice location
147 Avenida Serra Apt 207
San Clemente, CA 92672-4741
Mailing address
147 Avenida Serra Apt 207
San Clemente, CA 92672-4741
Phone (619) 818-2510
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
| License | State | Type | Specialty |
|---|---|---|---|
| 19026 | CA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1611187200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1611187200000",
"number": "1457941635",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "147 AVENIDA SERRA APT 207",
"city": "SAN CLEMENTE",
"state": "CA",
"postal_code": "926724741",
"telephone_number": "619-818-2510"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "147 AVENIDA SERRA APT 207",
"city": "SAN CLEMENTE",
"state": "CA",
"postal_code": "926724741",
"telephone_number": "619-818-2510"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PUENTE",
"first_name": "MARISA",
"name_prefix": "Dr.",
"credential": "DACM, L.AC.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-01-21",
"last_updated": "2021-01-21",
"certification_date": "2021-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "CA",
"license": "19026",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Clemente, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.