Individual provider Active NPI

Ionela O Hubbard, LAC, DOM, IFMCP

  • Acupuncturist
  • North Tustin, CA
National Provider Identifier
1790711935
Registry record updated Jul 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC4756 Issued in CA
Practice address
12341 Newport Ave Ste A200
North Tustin, CA 92705-8202
Phone
(949) 726-0707
Fax
(949) 258-8726
NPI assigned
Jun 22, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC4756 CA Primary
Nutrition Education Nutritionist 133NN1002X AC4756 CA

Addresses

Primary practice location

12341 Newport Ave Ste A200
North Tustin, CA 92705-8202

Mailing address

57 Plymouth
Irvine, CA 92620-2642
Phone (909) 478-0600

Other identifiers 2

IdentifierTypeStateIssuer
1790711935OtherCACMV
AC0047560MedicaidCA

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
AC4756CAMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721606400000",
    "number": "1790711935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 PLYMOUTH",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926202642",
            "telephone_number": "909-478-0600",
            "fax_number": "909-478-0618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12341 NEWPORT AVE STE A200",
            "city": "NORTH TUSTIN",
            "state": "CA",
            "postal_code": "927058202",
            "telephone_number": "949-726-0707",
            "fax_number": "949-258-8726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUBBARD",
        "first_name": "IONELA",
        "middle_name": "O",
        "credential": "LAC, DOM, IFMCP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-22",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC4756",
            "primary": true
        },
        {
            "code": "133NN1002X",
            "taxonomy_group": "",
            "desc": "Nutritionist, Nutrition, Education",
            "state": "CA",
            "license": "AC4756",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CMV",
            "identifier": "1790711935",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "AC0047560",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Tustin, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 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.