Mia Stableford, CMT

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

16509 Issued in CA

Practice address

17 Westwood Dr
San Francisco, CA 94112-1219

Phone

(415) 559-8169

NPI assigned

Jun 18, 2009

Last updated

Feb 11, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1245283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644537600000",
    "number": "1558598359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 WESTWOOD DR",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941121219",
            "telephone_number": "415-559-8169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 WESTWOOD DR",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941121219",
            "telephone_number": "415-559-8169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STABLEFORD",
        "first_name": "MIA",
        "credential": "CMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-18",
        "last_updated": "2022-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "16509",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "3559 Roundbarn Blvd",
            "city": "Santa Rosa",
            "state": "CA",
            "country_code": "US",
            "postal_code": "95403",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2022; 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.