Carla Antoinette Demaray
Individual provider Active NPI Chiropractor · Dixon, CA
NPI 1316008121 · NPPES record last updated Oct 12, 2015
Key facts
- NPI
- 1316008121
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 20161 (CA)
- Practice address
- 805 N Lincoln St
Suite E
Dixon, CA 95620-2172 - Phone
- (707) 455-8655
- NPI assigned
- Dec 13, 2006
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20161 | CA | MD | Family Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 20161 | CA | Yes |
Addresses
Primary practice location
805 N Lincoln St
Suite E
Dixon, CA 95620-2172
Mailing address
805 N Lincoln St
Suite E
Dixon, CA 95620-2172
Phone (707) 455-8655
Other providers in Dixon, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 12, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.