Healthcare Provider Details

I. General information

NPI: 1124137732
Provider Name (Legal Business Name): DONALD BOONE DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/29/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

144 STONY POINT ROAD
SANTA ROSA CA
95401
US

IV. Provider business mailing address

144 STONY POINT ROAD
SANTA ROSA CA
95401
US

V. Phone/Fax

Practice location:
  • Phone: 707-521-4500
  • Fax: 707-544-4626
Mailing address:
  • Phone: 707-521-4500
  • Fax: 707-544-4626

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC18337
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA15393
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: