Healthcare Provider Details

I. General information

NPI: 1194924167
Provider Name (Legal Business Name): DEEANN NASON DC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/11/2007
Last Update Date: 12/19/2023
Certification Date: 12/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1306 W GLENOAKS BLVD
GLENDALE CA
91201-2204
US

IV. Provider business mailing address

5612 SPA DR
HUNTINGTON BEACH CA
92647-2025
US

V. Phone/Fax

Practice location:
  • Phone: 818-247-4766
  • Fax: 818-247-5874
Mailing address:
  • Phone: 818-247-4766
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number20329
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: