MEDICARE: STONE SOUP ACUPUNCTURE PROFESSIONAL CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist

General Provider Information

NPI Number	:	1679419139
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STONE SOUP ACUPUNCTURE PROFESSIONAL CORPORATION

Provider Business Mailing Address
First Line	:	2124 5TH AVE
Second Line	:
City	:	OROVILLE
State	:	CA
Zip	:	95965-5862
Country	:	US
Telephone Number	:	530-712-9195
Fax Number	:	530-712-9171

Provider Business Practice Location Address
First Line	:	2124 5TH AVE
Second Line	:
City	:	OROVILLE
State	:	CA
Zip	:	95965-5862
Country	:	US
Telephone Number	:	530-712-9195
Fax Number	:	530-712-9171

Authorized Official
Title or Position	:	CEO
Name	:	LORI TATARU
Credential	:	L.AC.
Telephone Number	:	650-743-7260

Provider Enumeration Date	:	04/27/2026
Last Update Date	:	04/27/2026

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Directions to “STONE SOUP ACUPUNCTURE PROFESSIONAL CORPORATION ” Practice Location

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