This Notice describes how health information about you may be used and disclosed and how you can access this information. Please read it carefully.
Numinous Acupuncture and Alchemy is committed to protecting the privacy of your protected health information (PHI). PHI is information that can identify you and relates to your past, present, or future healthcare, treatment, or payment for healthcare. We are required by law to maintain the privacy of your PHI, provide you with this Notice, and notify you in the event of a breach of unsecured PHI. This Notice remains in effect until replaced.
Treatment
We may use and disclose your PHI to provide, coordinate, or manage your TCM care, including sharing relevant information with other providers to whom we refer you.
Payment
We may use and disclose your PHI to process payment and provide superbills for insurance reimbursement.
Healthcare Operations
We may use your PHI for quality improvement, practice administration, and professional obligations.
Special Circumstances
We may also use or disclose your PHI without your authorization when required or permitted by law, including: public health reporting; health oversight activities; court orders or legal proceedings; law enforcement; emergencies; workers’ compensation; coroners and funeral directors; and national security purposes.
Marketing & Sale of Information
We will obtain your written authorization before using your PHI for marketing purposes or any disclosure that constitutes a sale of PHI. You may revoke such authorization at any time in writing.
Right to Access & Copies
Inspect and receive copies of your PHI. Submit written requests at least 5 business days in advance. Fee: $0.30 per page, $15.00 minimum.
Right to Amend
Request amendment of incorrect or incomplete PHI by submitting a written request with your reason.
Right to Request Restrictions
Request restrictions on how we use or disclose your PHI. We are not required to agree but will comply if we do, except in emergencies.
Right to Confidential Communications
Request communication through alternative means or at an alternative location. We will accommodate reasonable requests.
Right to Accounting of Disclosures
Request a list of disclosures made of your PHI (not including treatment, payment, and operations disclosures). Specify a time period of no more than six years.
Right to Breach Notification
Be notified in the event of a breach of your unsecured PHI.
Right to a Paper Copy
Request a paper copy of this Notice at any time by contacting our office.
Right to File a Complaint
File a complaint with our practice or with the U.S. Department of Health and Human Services, Office for Civil Rights at 1-800-368-1019 or hhs.gov/ocr/privacy. We will not retaliate against you for filing a complaint.
Your medical information is also protected under California’s Confidentiality of Medical Information Act (CMIA), which provides additional privacy protections beyond HIPAA. We will not disclose your medical information without your written authorization except as permitted or required by law.
We use HIPAA-compliant communication tools through AcuBliss for appointment-related communications. For non-urgent matters you may also contact us at mari@numinousacupunctureandalchemy.com. Please be aware that standard email carries risks including forwarding, interception, and unintended recipients. Do not communicate with this practice by email if any of these risks concern you.
Do not use email for urgent health matters or emergencies – call (510) 770-6274 for urgent concerns and call 911 for medical emergencies.
Questions, rights requests, or complaints about our privacy practices:
Mari Kubota, LAc., Dipl.Ac., MSAOM
2381 Mariner Square Drive, Suite 175, Alameda, CA 94501
(510) 770-6274
mari@numinousacupunctureandalchemy.com
Effective date: April 2026 | Last updated: May 2026
