Healthcare Provider Details

I. General information

NPI: 1891576823
Provider Name (Legal Business Name): HENSTOCK CHIROPRACTIC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

21168 REDWOOD RD STE 100
CASTRO VALLEY CA
94546-5932
US

IV. Provider business mailing address

21168 REDWOOD RD STE 100
CASTRO VALLEY CA
94546-5932
US

V. Phone/Fax

Practice location:
  • Phone: 510-582-4880
  • Fax:
Mailing address:
  • Phone: 510-582-4880
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code111NP0017X
TaxonomyPediatric Chiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. REINHARDT HENSTOCK
Title or Position: PRESIDENT
Credential: DC
Phone: 510-582-4880