Healthcare Provider Details

I. General information

NPI: 1730227422
Provider Name (Legal Business Name): YANITSHA M. FELICIANO, D.C. INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2007
Last Update Date: 04/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6736 FRIENDS AVE
WHITTIER CA
90601-4432
US

IV. Provider business mailing address

18 BRENTANO DR
COTO DE CAZA CA
92679-4918
US

V. Phone/Fax

Practice location:
  • Phone: 562-698-1275
  • Fax: 562-698-7127
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License NumberDC18401
License Number StateCA

VIII. Authorized Official

Name: DR. YANITSHA M FELICIANO
Title or Position: CEO
Credential: D.C., D.A.B.C.O.
Phone: 562-698-1275