Healthcare Provider Details

I. General information

NPI: 1487640876
Provider Name (Legal Business Name): CATHRYN CHARETTE DC A CHIROPRACTIC CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2005
Last Update Date: 02/19/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

587 5TH ST W
SONOMA CA
95476-6831
US

IV. Provider business mailing address

587 5TH ST W
SONOMA CA
95476-6831
US

V. Phone/Fax

Practice location:
  • Phone: 707-935-1006
  • Fax: 707-935-7291
Mailing address:
  • Phone: 707-935-1006
  • Fax: 707-935-7291

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NX0100X
TaxonomyOccupational Health Chiropractor
License Number23764
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number23764
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code111NR0200X
TaxonomyRadiology Chiropractor
License Number23764
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License Number23764
License Number StateCA
# 5
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number23764
License Number StateCA

VIII. Authorized Official

Name: DR. ARTHUR LEON CHARETTE
Title or Position: PRESIDENT
Credential: DC
Phone: 707-935-1006