Healthcare Provider Details

I. General information

NPI: 1437583903
Provider Name (Legal Business Name): ERIC JOSEF DICKERSON DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/02/2013
Last Update Date: 05/29/2025
Certification Date: 05/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

352 PROVIDENCE MINE RD
NEVADA CITY CA
95959-2977
US

IV. Provider business mailing address

352 PROVIDENCE MINE RD
NEVADA CITY CA
95959-2977
US

V. Phone/Fax

Practice location:
  • Phone: 530-955-0065
  • Fax: 530-200-8865
Mailing address:
  • Phone: 530-955-0065
  • Fax: 530-200-8865

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number038012492
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code111NI0013X
TaxonomyIndependent Medical Examiner Chiropractor
License Number33998
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number33998
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: