Charissa Douglas, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC36310 Issued in CA

Practice address

17330 Bear Valley Rd
Ste 105
Victorville, CA 92395

Phone

(760) 245-8182

Fax

(760) 245-2123

NPI assigned

Sep 4, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Charissa Tam Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1536019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666051200000",
    "number": "1912489162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17330 BEAR VALLEY RD",
            "address_2": "STE 105",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "92395",
            "telephone_number": "760-245-8182",
            "fax_number": "760-245-2123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17330 BEAR VALLEY RD",
            "address_2": "STE 105",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "92395",
            "telephone_number": "760-245-8182",
            "fax_number": "760-245-2123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "CHARISSA",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-04",
        "last_updated": "2022-10-18",
        "certification_date": "2022-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC36310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHARISSA",
            "last_name": "TAM",
            "credential": "ATC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Francisco Angel Donan, RADTI
• Ed Dondelinger
• Casandra Lee Donley
• Vinay Dontul, MD
• Lamani Dorsey
• Doula
• Edward Downer
• Larry A Downey, M.A.
• Sharon Renee Doyle
• Dr, Mikel Walk in Clinic

• Chiropractor in Victorville, CA
• Providers in Victorville, CA by specialty
• Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2022; 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.