Individual provider Active NPI

Erin Vicencio, L.AC

  • Acupuncturist
  • Rolling Hills Estates, CA
National Provider Identifier
1740733450
Registry record updated Apr 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC17062 Issued in CA
Practice address
655 Deep Valley Dr
Suite 125 I-N
Rolling Hills Estates, CA 90274-3615
Phone
(424) 304-4522
NPI assigned
Jul 28, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 6, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC17062 CA Primary

Addresses

Primary practice location

655 Deep Valley Dr
Suite 125 I-N
Rolling Hills Estates, CA 90274-3615

Mailing address

655 Deep Valley Dr
Suite 125 I-N
Rolling Hills Estates, CA 90274-3615
Phone (424) 304-4522

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
AC17062CAMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1469664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491436800000",
    "number": "1740733450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 DEEP VALLEY DR",
            "address_2": "SUITE 125 I-N",
            "city": "ROLLING HILLS ESTATES",
            "state": "CA",
            "postal_code": "902743615",
            "telephone_number": "424-304-4522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 DEEP VALLEY DR",
            "address_2": "SUITE 125 I-N",
            "city": "ROLLING HILLS ESTATES",
            "state": "CA",
            "postal_code": "902743615",
            "telephone_number": "424-304-4522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICENCIO",
        "first_name": "ERIN",
        "credential": "L.AC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-28",
        "last_updated": "2017-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC17062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rolling Hills Estates, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2017; 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.