Healthcare Provider Details

I. General information

NPI: 1013432525
Provider Name (Legal Business Name): SONYA HEALTH & CHIROPRACTIC, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2017
Last Update Date: 10/07/2021
Certification Date: 10/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25499 MARVIN GARDENS WAY
MURRIETA CA
92563-5420
US

IV. Provider business mailing address

23811 WASHINGTON AVE STE C110-259
MURRIETA CA
92562-2275
US

V. Phone/Fax

Practice location:
  • Phone: 951-412-7838
  • Fax: 951-387-4659
Mailing address:
  • Phone: 951-387-4629
  • Fax: 951-387-4659

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number29166
License Number StateCA

VIII. Authorized Official

Name: AGAEZI SONYA
Title or Position: OWNER/CHIROPRACTOR
Credential: DC
Phone: 951-387-4629