Healthcare Provider Details

I. General information

NPI: 1972438976
Provider Name (Legal Business Name): ASCEND CHIROPRACTIC AND WELLNESS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2026
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 NORTHGATE DR STE 9
SAN RAFAEL CA
94903-3429
US

IV. Provider business mailing address

920 NORTHGATE DR STE 9
SAN RAFAEL CA
94903-3429
US

V. Phone/Fax

Practice location:
  • Phone: 415-578-2628
  • Fax:
Mailing address:
  • Phone: 415-578-2628
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: WILL LEE
Title or Position: OWNER
Credential: DC
Phone: 415-578-2628