Healthcare Provider Details

I. General information

NPI: 1902027477
Provider Name (Legal Business Name): NICOLE ELAINE TOENJES D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/01/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3708 MT DIABLO BLVD SUITE 120
LAFAYETTE CA
94549-3631
US

IV. Provider business mailing address

3708 MT DIABLO BLVD SUITE 120
LAFAYETTE CA
94549-3631
US

V. Phone/Fax

Practice location:
  • Phone: 925-283-6900
  • Fax: 925-283-6981
Mailing address:
  • Phone: 925-283-6900
  • Fax: 925-283-6981

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC30200
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: