Active NPI
Lacey Dupre, MSTOM
- Acupuncturist
- San Diego, CA
National Provider Identifier
1992233399
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 17695
- Practice address
- 4115 Texas St
San Diego, CA 92104-1615 - Phone
- (337) 298-3852
- NPI assigned
- May 30, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | 17695 | CA | Primary |
Addresses
Primary practice location
4115 Texas St
San Diego, CA 92104-1615
Mailing address
4115 Texas St
San Diego, CA 92104-1615
Phone (337) 298-3852
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1496102400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1992233399",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4115 TEXAS ST",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921041615",
"telephone_number": "337-298-3852"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4115 TEXAS ST",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921041615",
"telephone_number": "337-298-3852"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUPRE",
"first_name": "LACEY",
"credential": "MSTOM",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-05-30",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "CA",
"license": "17695",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.