Healthcare Provider Details

I. General information

NPI: 1528246758
Provider Name (Legal Business Name): PATRICIA MARIE HURLEY DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/11/2008
Last Update Date: 06/21/2023
Certification Date: 06/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10112 FAIR OAKS BLVD. SUITE #2
FAIR OAKS CA
95628
US

IV. Provider business mailing address

10112 FAIR OAKS BLVD. SUITE #2
FAIR OAKS CA
95628
US

V. Phone/Fax

Practice location:
  • Phone: 916-241-3696
  • Fax: 530-272-8161
Mailing address:
  • Phone: 916-241-3696
  • Fax: 530-272-8161

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number23529
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: