Healthcare Provider Details

I. General information

NPI: 1821054545
Provider Name (Legal Business Name): ERIN JEAN PADILLA D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/21/2006
Last Update Date: 09/08/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4895 CAPITOLA RD
CAPITOLA CA
95010-3810
US

IV. Provider business mailing address

4895 CAPITOLA RD
CAPITOLA CA
95010-3810
US

V. Phone/Fax

Practice location:
  • Phone: 831-440-7151
  • Fax: 831-476-7781
Mailing address:
  • Phone: 831-440-7151
  • Fax: 831-476-7781

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number1410
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number33864
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: