Healthcare Provider Details

I. General information

NPI: 1265178495
Provider Name (Legal Business Name): ELITE PERFORMANCE AND WELLNESS CENTER A CHENEY CHIROPRACTIC CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2022
Last Update Date: 08/16/2023
Certification Date: 08/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24009 VENTURA BLVD STE 200
CALABASAS CA
91302-2550
US

IV. Provider business mailing address

24009 VENTURA BLVD STE 200
CALABASAS CA
91302-2550
US

V. Phone/Fax

Practice location:
  • Phone: 888-608-6165
  • Fax: 818-208-7074
Mailing address:
  • Phone: 888-608-6165
  • Fax: 818-208-7074

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: DR. BRIANNA CHENEY
Title or Position: OWNER
Credential: DC, L.AC., DACBSP
Phone: 888-608-6165