Michelle Jean Champion, L.AC.

Individual provider Active NPI Acupuncturist · Lakeport, CA

NPI 1982205332 · NPPES record last updated Sep 26, 2024

Key facts

NPI
1982205332
Entity type
Individual (NPI type 1)
Primary specialty
Acupuncturist 171100000X
License
12768 (CA)
Practice address
925 Bevins CT
Lakeport, CA 95453-9754
Phone
(707) 263-8383
Fax
(707) 263-5019
NPI assigned
Nov 3, 2020
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

Interoperability endpoints

  • Direct secure messaging: michelle.champion.p1@direct.lcthc.nextgenshare.com

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 12768 CA Yes

Addresses

Primary practice location

925 Bevins CT
Lakeport, CA 95453-9754

Mailing address

PO Box 1950
Lakeport, CA 95453-1950
Phone (707) 263-8383

Other practice location 1

14440 Olympic Drive
Clearlake, CA 95422-8809
Phone (707) 263-8383

Other names

  • Michelle Jean Bummins Former name

Other providers in Lakeport, CA

All providers in Lakeport, CA · Acupuncturist in California

Sources for this page

Verify at the official NPI Registry.