Healthcare Provider Details

I. General information

NPI: 1699706044
Provider Name (Legal Business Name): STEVEN J. HERRIN, D.C., A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

467 N WILMA AVE SUITE 10
RIPON CA
95366-9538
US

IV. Provider business mailing address

467 N WILMA AVE SUITE 10
RIPON CA
95366-9538
US

V. Phone/Fax

Practice location:
  • Phone: 209-599-1789
  • Fax: 209-599-1787
Mailing address:
  • Phone: 209-599-1789
  • Fax: 209-599-1787

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC 26062
License Number StateCA

VIII. Authorized Official

Name: STEVEN J HERRIN
Title or Position: D.C./PRESIDENT
Credential: D.C.
Phone: 209-599-1789