Stephanie Duerkopp Faddis

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

16967 Issued in CA

Practice address

609 S Vulcan Ave
Suite 201
Encinitas, CA 92024-3600

Phone

(626) 555-5555

NPI assigned

May 7, 2016

Last updated

Sep 22, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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": "1462579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474502400000",
    "number": "1992151013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1237 COLUMBUS WAY",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920818942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 S VULCAN AVE",
            "address_2": "SUITE 201",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920243600",
            "telephone_number": "626-555-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FADDIS",
        "first_name": "STEPHANIE",
        "middle_name": "DUERKOPP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-07",
        "last_updated": "2016-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "16967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Acupuncturist in Encinitas, CA
• Providers in Encinitas, CA by specialty
• Acupuncturist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2016; 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.