Healthcare Provider Details

I. General information

NPI: 1699562025
Provider Name (Legal Business Name): RAISA CIPRIANO DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2025
Last Update Date: 04/21/2025
Certification Date: 04/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6200 CANOGA AVE STE 110
WOODLAND HILLS CA
91367-7793
US

IV. Provider business mailing address

6200 CANOGA AVE STE 110
WOODLAND HILLS CA
91367-7793
US

V. Phone/Fax

Practice location:
  • Phone: 909-287-4055
  • Fax:
Mailing address:
  • Phone: 909-287-4055
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number35145
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: