Destin Joseph Radder, L.AC.

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

004488 Issued in NY

Practice address

627 Center St
Santa Cruz, CA 95060-3804

Phone

(831) 426-5044

NPI assigned

Oct 3, 2008

Last updated

Nov 11, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

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": "1222992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289433600000",
    "number": "1487805834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5320 MILITARY RD",
            "address_2": "SUITE 104",
            "city": "LEWISTON",
            "state": "NY",
            "postal_code": "140922149",
            "telephone_number": "716-297-9379",
            "fax_number": "716-297-4638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "627 CENTER ST",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950603804",
            "telephone_number": "831-426-5044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADDER",
        "first_name": "DESTIN",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "L.AC.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-03",
        "last_updated": "2010-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "12344",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NY",
            "license": "004488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Raasch
• Julianna M Rabanal-Miceli, RN
• Laura Lynn Rabb-Jancola
• Jessica Leahlea Radcliff
• Judith Radcliffe, PT
• Radiology Medical Group of Santa Cruz County Inc
• Radiology Medical Group of Santa Cruz County Inc
• Radiology Medical Group of Santa Cruz County Inc
• Radiology Medical Group of Santa Cruz County Inc
• Sarah Michal Radosh, MHW

• Acupuncturist in Santa Cruz, CA
• Providers in Santa Cruz, CA by specialty
• Acupuncturist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2010; 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.