Healthcare Provider Details

I. General information

NPI: 1588130983
Provider Name (Legal Business Name): VALERIE A LYON DC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/23/2018
Last Update Date: 04/23/2025
Certification Date: 04/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

328 SATURN CT
NIPOMO CA
93444-9612
US

IV. Provider business mailing address

27661 ORLANDO AVE
HAYWARD CA
94545-4752
US

V. Phone/Fax

Practice location:
  • Phone: 805-391-7833
  • Fax:
Mailing address:
  • Phone: 510-896-5901
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number34318
License Number StateCA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: