Individual provider Active NPI

Timothy Joseph Ross, EAMP, L.AC.

  • Acupuncturist
  • Big Bear Lake, CA
National Provider Identifier
1962895342
Registry record updated Apr 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
20342 Issued in CA
Practice address
306 Santa Clara Blvd
Big Bear Lake, CA 92315-9816
Phone
(714) 915-2301
NPI assigned
Mar 10, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 30, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC 60432768 WA
Acupuncturist 171100000X 20342 CA Primary

Addresses

Primary practice location

306 Santa Clara Blvd
Big Bear Lake, CA 92315-9816

Mailing address

PO Box 6657
Big Bear Lake, CA 92315-6657
Phone (714) 915-2301

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
20342CAMDClinical Social Worker
AC 60432768WAMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1425945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745971200000",
    "number": "1962895342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6657",
            "city": "BIG BEAR LAKE",
            "state": "CA",
            "postal_code": "923156657",
            "telephone_number": "714-915-2301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 SANTA CLARA BLVD",
            "city": "BIG BEAR LAKE",
            "state": "CA",
            "postal_code": "923159816",
            "telephone_number": "714-915-2301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "TIMOTHY",
        "middle_name": "JOSEPH",
        "credential": "EAMP, L.AC.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-03-10",
        "last_updated": "2025-04-30",
        "certification_date": "2025-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "WA",
            "license": "AC 60432768",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "20342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Big Bear Lake, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 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.