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General NPI Number Information
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NPI Number | 1033812433
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Entity Type | Individual
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Provider Name | JOHN DEVON HERRERA
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Gender | Male
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Dates
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Enumeration Date | 03/24/2023
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Last Update Date | 03/25/2023
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Provider Practice Location Address
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Address Line | 1841 W COMMONWEALTH AVE
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City | FULLERTON
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State | CA
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Zip | 92833-3013
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Country | US
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Telephone | 951-961-6410
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Fax |
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Provider Business Mailing Address
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Address Line | 1841 W COMMONWEALTH AVE
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City | FULLERTON
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State | CA
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Zip | 92833-3013
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Country | US
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Telephone | 951-961-6410
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 35173
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License Number State | CA
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