Active NPI
Sandra Waters, D.C.
- Chiropractor
- Crescent City, CA
National Provider Identifier
1669698874
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- DC14804
- Practice address
- 200 Darby St
Crescent City, CA 95531-9156 - Phone
- (707) 464-2811
- Fax
- (707) 464-8211
- NPI assigned
- Apr 17, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | DC14804 | CA | Primary |
Addresses
Primary practice location
200 Darby St
Crescent City, CA 95531-9156
Mailing address
200 Darby St
Crescent City, CA 95531-9156
Phone (707) 464-2811
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DC0148040 | Other | CA | BLUE SHIELD CA |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DC14804 | CA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176768000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1669698874",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 DARBY ST",
"city": "CRESCENT CITY",
"state": "CA",
"postal_code": "955319156",
"telephone_number": "707-464-2811",
"fax_number": "707-464-8211"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 DARBY ST",
"city": "CRESCENT CITY",
"state": "CA",
"postal_code": "955319156",
"telephone_number": "707-464-2811",
"fax_number": "707-464-8211"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATERS",
"first_name": "SANDRA",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "DC14804",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD CA",
"identifier": "DC0148040",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Crescent City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.