Individual provider Active NPI

Jaclyn Adamcewicz, DACM, L.AC.

  • Acupuncturist
  • San Diego, CA
National Provider Identifier
1689379539
Registry record updated Mar 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
19007 Issued in CA
Practice address
4410 1/2 Lamont St
San Diego, CA 92109-4515
Phone
(631) 806-5993
NPI assigned
Mar 31, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 31, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 19007 CA Primary

Addresses

Primary practice location

4410 1/2 Lamont St
San Diego, CA 92109-4515

Mailing address

5783 Mission Center Rd Apt 309
San Diego, CA 92108-4918
Phone (631) 806-5993

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

LicenseStateTypeSpecialty
19007CAMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1680220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680220800000",
    "number": "1689379539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5783 MISSION CENTER RD APT 309",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921084918",
            "telephone_number": "631-806-5993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4410 1/2 LAMONT ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921094515",
            "telephone_number": "631-806-5993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADAMCEWICZ",
        "first_name": "JACLYN",
        "credential": "DACM, L.AC.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-31",
        "last_updated": "2023-03-31",
        "certification_date": "2023-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "19007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2023; 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.