Active NPI
Amanda Miller, LAC.
- Acupuncturist
- Manteca, CA
National Provider Identifier
1881136935
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- AC 17358
- Practice address
- 450 Vin Rose Way
Manteca, CA 95337-6831 - Phone
- (209) 456-2206
- NPI assigned
- Nov 7, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | AC 17358 | CA | Primary |
Addresses
Primary practice location
450 Vin Rose Way
Manteca, CA 95337-6831
Mailing address
450 Vin Rose Way
Manteca, CA 95337-6831
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq | Health Information Exchange (HIE) | The Permanente Medical Group |
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
| License | State | Type | Specialty |
|---|---|---|---|
| AC 17358 | CA | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1478476800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1644537600000",
"number": "1881136935",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "450 VIN ROSE WAY",
"city": "MANTECA",
"state": "CA",
"postal_code": "953376831"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "450 VIN ROSE WAY",
"city": "MANTECA",
"state": "CA",
"postal_code": "953376831",
"telephone_number": "209-456-2206"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "AMANDA",
"credential": "LAC.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-11-07",
"last_updated": "2022-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "CA",
"license": "AC 17358",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
"affiliation": "Y",
"endpointDescription": "Carequality",
"affiliationName": "The Permanente Medical Group",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "6600 Bruceville Rd",
"city": "Sacramento",
"state": "CA",
"country_code": "US",
"postal_code": "95823",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Manteca, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 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.