Healthcare Provider Details

I. General information

NPI: 1457655409
Provider Name (Legal Business Name): TRISHA MARIE WIMBS D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/05/2011
Last Update Date: 03/13/2023
Certification Date: 03/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

755 SUNRISE AVE SUITE 115
ROSEVILLE CA
95661-4500
US

IV. Provider business mailing address

755 SUNRISE AVE SUITE 115
ROSEVILLE CA
95661-4500
US

V. Phone/Fax

Practice location:
  • Phone: 916-786-6055
  • Fax: 916-786-6452
Mailing address:
  • Phone: 916-786-6055
  • Fax: 916-786-6452

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number31771
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: