State of the Heart Wellness

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC23580 Issued in CA

Legal business name

STATE OF THE HEART WELLNESS

Practice address

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

Phone

(408) 972-5686

Fax

(408) 972-5682

NPI assigned

Feb 2, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Tina Roach-Gagnon, DCNPI 1255567509

Title

Owner 50/50

Phone

(408) 972-5686

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tina Marie Roach-Gagnon, DC

  • Nutrition Chiropractor
  • San Jose, CA
  • NPI 1255567509
  NPD (past) Authorized official

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

{
    "created_epoch": "1485993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490832000000",
    "number": "1386182079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7174 SANTA TERESA BLVD 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 STE A7",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951391350",
            "telephone_number": "408-972-5686",
            "fax_number": "408-972-5682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF THE HEART WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-02",
        "last_updated": "2017-03-30",
        "status": "A",
        "authorized_official_last_name": "ROACH-GAGNON",
        "authorized_official_first_name": "TINA",
        "authorized_official_title_or_position": "OWNER 50/50",
        "authorized_official_telephone_number": "408-972-5686",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC23580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard W Starrett, MD
• Stephanie Ann Starritt
• Janet Elaine Stashak, MA, MFT
• Stason K. Shishido, D.D.S. Inc.
• State of California - Department of Developmental Services
• Audrey Danielle Staton
• Rhonda Staton
• Joanna U Staunton, MD
• Jennifer Stavreva
• STDK Medical Inc.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2017; 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.