Individual provider Active NPI

Bryan William Watrous, DACM, L.AC

  • Acupuncturist
  • Yorba Linda, CA
National Provider Identifier
1790430742
Registry record updated Feb 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
19353 Issued in CA
Practice address
5620 Calle Vista Alegre
Yorba Linda, CA 92887-2465
Phone
(949) 343-1622
NPI assigned
Feb 18, 2022
Last updated
Feb 18, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 19353 CA Primary

Addresses

Primary practice location

5620 Calle Vista Alegre
Yorba Linda, CA 92887-2465

Mailing address

5620 Calle Vista Alegre
Yorba Linda, CA 92887-2465
Phone (949) 343-1622

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
19353CAMDVeterinarian

NPI Registry JSON

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

{
    "created_epoch": "1645142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645142400000",
    "number": "1790430742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5620 CALLE VISTA ALEGRE",
            "city": "YORBA LINDA",
            "state": "CA",
            "postal_code": "928872465",
            "telephone_number": "949-343-1622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5620 CALLE VISTA ALEGRE",
            "city": "YORBA LINDA",
            "state": "CA",
            "postal_code": "928872465",
            "telephone_number": "949-343-1622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATROUS",
        "first_name": "BRYAN",
        "middle_name": "WILLIAM",
        "credential": "DACM, L.AC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-02-18",
        "last_updated": "2022-02-18",
        "certification_date": "2022-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "19353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yorba Linda, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2022; 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.