Tina Marie Roach-Gagnon, DC

Primary specialty

Nutrition ChiropractorTaxonomy code 111NN1001X

License

DC23580 Issued in CA

Practice address

7174 Santa Teresa Blvd
Ste A7
San Jose, CA 95139-1350

Phone

(408) 972-5686

NPI assigned

Jun 1, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• State of the Heart Wellness

  • Chiropractor
  • San Jose, CA
  • NPI 1386182079
  NPD (past) Authorized official

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

{
    "created_epoch": "1243814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482105600000",
    "number": "1255567509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7174 SANTA TERESA BLVD",
            "address_2": "STE A7",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951391350",
            "telephone_number": "408-972-5686",
            "fax_number": "408-972-5682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7174 SANTA TERESA BLVD",
            "address_2": "STE A7",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951391350",
            "telephone_number": "408-972-5686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROACH-GAGNON",
        "first_name": "TINA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-01",
        "last_updated": "2016-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NN1001X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Nutrition",
            "state": "CA",
            "license": "DC23580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victoria Rizzato
• Arthur J Rizzi Jr., PHD, MFT
• Ashley Ro, AC
• Monserrat Roa Diaz
• Kaely Roa
• Jackson Roach
• Destiny Roacho
• Roadrunner Express
• Roaming Naturopath
• Samantha Roan, MA, BCBA

• Nutrition Chiropractor in San Jose, CA
• Providers in San Jose, CA by specialty
• Nutrition Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2016; 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.