Active NPI
Stephanie Fenter, L.AC., DIPL.AC.
- Acupuncturist
- Alameda, CA
National Provider Identifier
1700129723
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 14671
- Practice address
- 1050 Marina Village Pkwy Ste 104
Alameda, CA 94501-1033 - Phone
- (510) 603-0915
- NPI assigned
- Mar 27, 2013
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | 00010 | MS | |
| Acupuncturist | 171100000X | 152722 | ||
| Acupuncturist | 171100000X | 14671 | Primary |
Addresses
Primary practice location
1050 Marina Village Pkwy Ste 104
Alameda, CA 94501-1033
Mailing address
149 N Central Ave
Ridgeland, MS 39157-2334
Other practice location 1
300 Beverly Cir
Crystal Springs, MS 39059-2405
Phone (510) 603-0915
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 14671 | Other | CA | CA STATE ACUPUNCTURE LICENSE |
| 152722 | Other | NCCAOM CERTIFICATION | |
| 00010 | Other | MS ACUPUNCTURE LICENSE |
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 |
|---|---|---|---|
| 00010 | MS | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1364342400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1747094400000",
"number": "1700129723",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "149 N CENTRAL AVE",
"city": "RIDGELAND",
"state": "MS",
"postal_code": "391572334"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1050 MARINA VILLAGE PKWY STE 104",
"city": "ALAMEDA",
"state": "CA",
"postal_code": "945011033",
"telephone_number": "510-603-0915"
}
],
"practiceLocations": [
{
"address_1": "300 Beverly Cir",
"address_purpose": "LOCATION",
"city": "Crystal Springs",
"state": "MS",
"postal_code": "390592405",
"country_code": "US",
"telephone_number": "510-603-0915",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FENTER",
"first_name": "STEPHANIE",
"credential": "L.AC., DIPL.AC.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-03-27",
"last_updated": "2025-05-13",
"certification_date": "2025-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "MS",
"license": "00010",
"primary": false
},
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": null,
"license": "152722",
"primary": false
},
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": null,
"license": "14671",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CA STATE ACUPUNCTURE LICENSE",
"identifier": "14671",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCCAOM CERTIFICATION",
"identifier": "152722",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MS ACUPUNCTURE LICENSE",
"identifier": "00010",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Alameda, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.