Individual provider Active NPI

Kimberly Hoover, LAC

  • Acupuncturist
  • Penn Valley, CA
National Provider Identifier
1700893773
Registry record updated Dec 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
4093 Issued in CA
Practice address
13779 Falling Leaf LN
Penn Valley, CA 95946-9350
Phone
(619) 992-8068
NPI assigned
Aug 2, 2006
Last updated
Dec 1, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 1, 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 4093 CA Primary

Addresses

Primary practice location

13779 Falling Leaf LN
Penn Valley, CA 95946-9350

Mailing address

PO Box 1625
Penn Valley, CA 95946-1625
Phone (619) 992-8068

Other identifiers 1

IdentifierTypeStateIssuer
GAC000250MedicaidCA

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kimberly Hoover L.Ac. Acupuncturist Current Accepting new patients

Locations

2852 Adams Ave
San Diego, CA 92116
Phone (619) 548-0701

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701388800000",
    "number": "1700893773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1625",
            "city": "PENN VALLEY",
            "state": "CA",
            "postal_code": "959461625",
            "telephone_number": "619-992-8068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13779 FALLING LEAF LN",
            "city": "PENN VALLEY",
            "state": "CA",
            "postal_code": "959469350",
            "telephone_number": "619-992-8068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOOVER",
        "first_name": "KIMBERLY",
        "name_prefix": "Ms.",
        "credential": "LAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-02",
        "last_updated": "2023-12-01",
        "certification_date": "2023-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "4093",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GAC000250",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Penn Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 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.