Active NPI
Emily Jasmine Head, LAC, MAOM
- Acupuncturist
- Fort Bragg, CA
National Provider Identifier
1528386505
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- AC 13564
- Practice address
- 250 N Main St
Suite E
Fort Bragg, CA 95437-3622 - Phone
- (707) 969-7679
- NPI assigned
- May 14, 2010
- 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 | AC 13564 | CA | Primary |
Addresses
Primary practice location
250 N Main St
Suite E
Fort Bragg, CA 95437-3622
Mailing address
31360 Highway 20
Fort Bragg, CA 95437-9270
Phone (707) 969-7679
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 |
|---|---|---|---|
| AC 13564 | CA | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1273795200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1315958400000",
"number": "1528386505",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "31360 HIGHWAY 20",
"city": "FORT BRAGG",
"state": "CA",
"postal_code": "954379270",
"telephone_number": "707-969-7679"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "250 N MAIN ST",
"address_2": "SUITE E",
"city": "FORT BRAGG",
"state": "CA",
"postal_code": "954373622",
"telephone_number": "707-969-7679"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEAD",
"first_name": "EMILY",
"middle_name": "JASMINE",
"name_prefix": "Miss",
"credential": "LAC, MAOM",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-05-14",
"last_updated": "2011-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "CA",
"license": "AC 13564",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Bragg, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.