Individual provider Active NPI

Deborah W Wollum, DC

  • Chiropractor
  • Simi Valley, CA
National Provider Identifier
1962579672
Registry record updated May 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC20444 Issued in CA
Practice address
2232 McDonald St
Simi Valley, CA 93065-2425
Phone
(805) 377-7610
Fax
(805) 306-1571
NPI assigned
Nov 29, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC20444 CA Primary

Addresses

Primary practice location

2232 McDonald St
Simi Valley, CA 93065-2425

Mailing address

2232 McDonald St
Simi Valley, CA 93065-2425
Phone (805) 377-7610

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
DC20444CAMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746489600000",
    "number": "1962579672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2232 MCDONALD ST",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930652425",
            "telephone_number": "805-377-7610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2232 MCDONALD ST",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930652425",
            "telephone_number": "805-377-7610",
            "fax_number": "805-306-1571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLLUM",
        "first_name": "DEBORAH",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-29",
        "last_updated": "2025-05-06",
        "certification_date": "2025-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC20444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Simi Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2025; 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.