=====================================================
General NPI Number Information
=====================================================
NPI Number | 1134090616
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SUPRAI CHIROPRACTIC INCORPORATED
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/16/2025
-----------------------------------------------------
Last Update Date | 02/04/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6049 DOUGLAS BLVD STE 4
-----------------------------------------------------
City | GRANITE BAY
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95746-6249
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 916-872-1999
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6049 DOUGLAS BLVD STE 4
-----------------------------------------------------
City | GRANITE BAY
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95746-6249
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 916-872-1999
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CHIROPRACTOR
-----------------------------------------------------
Name | DR. SOPHIA DANIELLE SUPRAI
-----------------------------------------------------
Credential | DC
-----------------------------------------------------
Telephone | 707-330-9820
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------