Healthcare Provider Details

I. General information

NPI: 1679419139
Provider Name (Legal Business Name): STONE SOUP ACUPUNCTURE PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2124 5TH AVE
OROVILLE CA
95965-5862
US

IV. Provider business mailing address

2124 5TH AVE
OROVILLE CA
95965-5862
US

V. Phone/Fax

Practice location:
  • Phone: 530-712-9195
  • Fax: 530-712-9171
Mailing address:
  • Phone: 530-712-9195
  • Fax: 530-712-9171

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: LORI TATARU
Title or Position: CEO
Credential: L.AC.
Phone: 650-743-7260