Active NPI
Melissa Renee Kallsen, L.AC
- Acupuncturist
- Venice, CA
National Provider Identifier
1891125019
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- AC 15533
- Practice address
- 122 Lincoln Blvd
Suite #201 C
Venice, CA 90291-2826 - Phone
- (310) 428-6011
- NPI assigned
- Nov 25, 2013
- 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 15533 | CA | Primary |
Addresses
Primary practice location
122 Lincoln Blvd
Suite #201 C
Venice, CA 90291-2826
Mailing address
122 Lincoln Blvd
Suite #201 C
Venice, CA 90291-2826
Phone (310) 428-6011
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 15533 | CA | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1385337600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1385337600000",
"number": "1891125019",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "122 LINCOLN BLVD",
"address_2": "SUITE #201 C",
"city": "VENICE",
"state": "CA",
"postal_code": "902912826",
"telephone_number": "310-428-6011"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "122 LINCOLN BLVD",
"address_2": "SUITE #201 C",
"city": "VENICE",
"state": "CA",
"postal_code": "902912826",
"telephone_number": "310-428-6011"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KALLSEN",
"first_name": "MELISSA",
"middle_name": "RENEE",
"credential": "L.AC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-11-25",
"last_updated": "2013-11-25",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "CA",
"license": "AC 15533",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Venice, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.