Healthcare Provider Details

I. General information

NPI: 1255971032
Provider Name (Legal Business Name): CHELSEA AZARCON NMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2020
Last Update Date: 01/09/2020
Certification Date: 01/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

185 CHERRY AVE
AUBURN CA
95603-4811
US

IV. Provider business mailing address

7122 BAYRIDGE CT
GRANITE BAY CA
95746-6507
US

V. Phone/Fax

Practice location:
  • Phone: 916-512-9886
  • Fax:
Mailing address:
  • Phone: 916-512-9556
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License NumberND1134
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: