=====================================================
General NPI Number Information
=====================================================
NPI Number | 1811565807
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JONI CHAPMAN DACM, LAC, CFMP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/15/2021
-----------------------------------------------------
Last Update Date | 06/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9932 MAINE AVE
-----------------------------------------------------
City | LAKESIDE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92040-3108
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 619-592-1760
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9932 MAINE AVE
-----------------------------------------------------
City | LAKESIDE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92040-3108
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 619-592-1760
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 171100000X
-----------------------------------------------------
Taxonomy Name | Acupuncturist
-----------------------------------------------------
License Number | 19155
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------