Fred Siciliano, L.AC.(LICENSED ACUPU

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

0495 Issued in AZ

Practice address

9151 E Swift Trail Dr
Prescott Valley, AZ 86314-7346

Phone

(805) 654-8776

NPI assigned

Jan 28, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Fred Siciliano Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1296172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733097600000",
    "number": "1902102619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26424",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "863126424",
            "telephone_number": "805-654-8776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9151 E SWIFT TRAIL DR",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "863147346",
            "telephone_number": "805-654-8776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SICILIANO",
        "first_name": "FRED",
        "name_prefix": "Dr.",
        "credential": "L.AC.(LICENSED ACUPU",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-01-28",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC1315",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "AZ",
            "license": "0495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "FRED",
            "last_name": "SICILIANO",
            "prefix": "DR.",
            "credential": "OMD, LAC, MH",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Acupuncturist in Prescott Valley, AZ
• Providers in Prescott Valley, AZ by specialty
• Acupuncturist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 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.