Healthcare Provider Details

I. General information

NPI: 1053241752
Provider Name (Legal Business Name): LOTUS FLOWER ACUPUNCTURE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2026
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5555 RESERVOIR DR STE 314
SAN DIEGO CA
92120-5150
US

IV. Provider business mailing address

5030 LAKIBA PALMER AVE
SAN DIEGO CA
92102-3746
US

V. Phone/Fax

Practice location:
  • Phone: 619-943-0162
  • Fax:
Mailing address:
  • Phone: 619-943-0162
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JANEL MARIE RICHARDSON
Title or Position: CEO
Credential: LAC
Phone: 619-943-0162