The Glow Studio Acupuncture, Professional Corporation

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

THE GLOW STUDIO ACUPUNCTURE, PROFESSIONAL CORPORATION

Practice address

1615 Hill Rd Ste G
Novato, CA 94947-4338

Phone

(415) 761-1440

NPI assigned

Mar 8, 2024

Organization subpart

No

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

Authorized official

Name

Lorrie B Fissenden, L.AC., MSTCMNPI 1164928404

Title

Ceo

Phone

(816) 739-2457

Specialties & licenses 1

Addresses

Other names 1

• The Glow Studio Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lorrie Barnett Fissenden, MSOM, L.AC.

  • Acupuncturist
  • Novato, CA
  • NPI 1164928404
  NPD Authorized official

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

{
    "created_epoch": "1709856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709856000000",
    "number": "1730947243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "624 CANYON RD",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949474305",
            "telephone_number": "816-739-2457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 HILL RD STE G",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949474338",
            "telephone_number": "415-761-1440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE GLOW STUDIO ACUPUNCTURE, PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-08",
        "last_updated": "2024-03-08",
        "certification_date": "2024-03-08",
        "status": "A",
        "authorized_official_last_name": "FISSENDEN",
        "authorized_official_first_name": "LORRIE",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "816-739-2457",
        "authorized_official_credential": "L.AC., MSTCM"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Glow Studio",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Laurel Te Velde
• Isaac Teckie
• Richard Franklin Teel, D.C.
• Rainey Sealey Temkin, PHD
• Stephen Paul Ternlund, MD
• Thomas P Young PHD NP PC
• Thomas R. Bales DDS Inc
• Jessica Christine Thomas, LMFT
• Jeanine Grialou Thompson, MPT
• Joy Thorstad

• Clinic/Center in Novato, CA
• Providers in Novato, CA by specialty
• Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2024; 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.