Individual provider Active NPI

Leta Beth Jussila, DAOM

  • Acupuncturist
  • Santa Cruz, CA
National Provider Identifier
1962622423
Registry record updated Sep 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
10935 Issued in CA
Practice address
3335 Mission Dr
Santa Cruz, CA 95065-1827
Phone
(831) 222-0189
Fax
(831) 428-0101
NPI assigned
Apr 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 10935 CA Primary

Addresses

Primary practice location

3335 Mission Dr
Santa Cruz, CA 95065-1827

Mailing address

1618 King Street
Santa Cruz, CA 95060-5204
Phone (831) 239-9326

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
10935CAMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Doctor Leta Inc. CurrentSince Mar 24, 2024 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694131200000",
    "number": "1962622423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1618 KING STREET",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950605204",
            "telephone_number": "831-239-9326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3335 MISSION DR",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950651827",
            "telephone_number": "831-222-0189",
            "fax_number": "831-428-0101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUSSILA",
        "first_name": "LETA",
        "middle_name": "BETH",
        "name_prefix": "Dr.",
        "credential": "DAOM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-26",
        "last_updated": "2023-09-08",
        "certification_date": "2023-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "10935",
            "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 Sep 8, 2023; 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.