Individual provider Active NPI

Sheila Roselo Donnelly, D.C.

  • Chiropractor
  • San Leandro, CA
National Provider Identifier
1316368335
Registry record updated Dec 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC 32685 Issued in CA
Practice address
369 Juana Ave
San Leandro, CA 94577-4810
Phone
(510) 316-3917
Fax
(510) 357-1365
NPI assigned
Dec 17, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC 32685 CA Primary

Addresses

Primary practice location

369 Juana Ave
San Leandro, CA 94577-4810

Mailing address

369 Juana Ave
San Leandro, CA 94577-4810
Phone (510) 316-3917

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC 32685CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Manibog Chiropractic Center Inc Chiropractor PastSince Sep 16, 1997 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1387238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387238400000",
    "number": "1316368335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "369 JUANA AVE",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945774810",
            "telephone_number": "510-316-3917",
            "fax_number": "510-357-1365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "369 JUANA AVE",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945774810",
            "telephone_number": "510-316-3917",
            "fax_number": "510-357-1365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONNELLY",
        "first_name": "SHEILA",
        "middle_name": "ROSELO",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-12-17",
        "last_updated": "2013-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC 32685",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Leandro, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2013; 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.