Individual provider Active NPI

Shirley Suk-Yee Kan, LAC, PHARM.D.

  • Acupuncturist
  • Castro Valley, CA
National Provider Identifier
1548219009
Registry record updated Dec 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC10688 Issued in CA
Practice address
20392 Yeandle Ave
Castro Valley, CA 94546-4421
Phone
(510) 461-4393
NPI assigned
May 10, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 3, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC10688 CA Primary

Addresses

Primary practice location

20392 Yeandle Ave
Castro Valley, CA 94546-4421

Mailing address

20392 Yeandle Ave
Castro Valley, CA 94546-4421
Phone (510) 461-4393

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
AC10688CAMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354492800000",
    "number": "1548219009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20392 YEANDLE AVE",
            "city": "CASTRO VALLEY",
            "state": "CA",
            "postal_code": "945464421",
            "telephone_number": "510-461-4393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20392 YEANDLE AVE",
            "city": "CASTRO VALLEY",
            "state": "CA",
            "postal_code": "945464421",
            "telephone_number": "510-461-4393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAN",
        "first_name": "SHIRLEY",
        "middle_name": "SUK-YEE",
        "credential": "LAC, PHARM.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-10",
        "last_updated": "2012-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC10688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Castro Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2012; 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.