Individual provider Active NPI

Evelyn Skultety, DTCM, LAC, CFMC

  • Acupuncturist
  • Santa Cruz, CA
National Provider Identifier
1871216101
Registry record updated Mar 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
19178 Issued in CA
Practice address
52 Tanglewood TRL
Santa Cruz, CA 95060-1432
Phone
(831) 600-6321
NPI assigned
Sep 21, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
AcupuncturistGroup: 193400000X SINGLE SPECIALTY GROUP 171100000X 19178 CA Primary

Addresses

Primary practice location

52 Tanglewood TRL
Santa Cruz, CA 95060-1432

Mailing address

52 Tanglewood TRL
Santa Cruz, CA 95060-1432
Phone (831) 600-6321

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
19178CAMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1663718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741046400000",
    "number": "1871216101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 TANGLEWOOD TRL",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950601432",
            "telephone_number": "831-600-6321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52 TANGLEWOOD TRL",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950601432",
            "telephone_number": "831-600-6321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKULTETY",
        "first_name": "EVELYN",
        "credential": "DTCM, LAC, CFMC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-21",
        "last_updated": "2025-03-04",
        "certification_date": "2025-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "19178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Cruz, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2025; 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.