Mahsa Etesam

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC36128 Issued in CA

Practice address

2020 S Bascom Ave Ste 103
Campbell, CA 95008-3269

Phone

(408) 866-8820

NPI assigned

Jul 28, 2021

Last updated

Jul 28, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Corelite Chiropractic and Wellness

  • Chiropractor
  • Campbell, CA
  • NPI 1982385415
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1627430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627430400000",
    "number": "1033882782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "916 FONT TER",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951263592",
            "telephone_number": "765-337-9896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 S BASCOM AVE STE 103",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "950083269",
            "telephone_number": "408-866-8820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETESAM",
        "first_name": "MAHSA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-28",
        "last_updated": "2021-07-28",
        "certification_date": "2021-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC36128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Campbell",
            "affiliation": "N",
            "endpointDescription": "Chiropractic office",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2020 S Bascom Ave Ste 103",
            "city": "Campbell",
            "state": "CA",
            "country_code": "US",
            "postal_code": "950083269",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Abby Estrada
• Anthony Estrada, M.A.
• Vannesa Marie Estrada
• Esvyda Health
• Esvyda, Inc.
• Brittni Evans
• Kambria H Evans, MED, LMFT
• Tochie Ezeife
• F. Richard Noodleman MD a Professional Corporation (Age Defy Dermatology and Wellness Incorporated)
• Keith A. Fabisiak, MD

• Chiropractor in Campbell, CA
• Providers in Campbell, CA by specialty
• Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.