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General NPI Number Information
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NPI Number | 1508187667
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Entity Type | Individual
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Provider Name | MARSHEA DARLENE WATSON D.C.
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Gender | Female
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Dates
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Enumeration Date | 06/11/2010
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Last Update Date | 12/03/2018
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Provider Practice Location Address
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Address Line | 1068 E 14TH ST
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City | SAN LEANDRO
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State | CA
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Zip | 94577-3731
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Country | US
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Telephone | 510-569-5500
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Fax | 510-569-5501
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Provider Business Mailing Address
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Address Line | 1068 E 14TH ST STE 310
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City | SAN LEANDRO
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State | CA
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Zip | 94577-3731
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Country | US
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Telephone | 510-569-5500
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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 | 31571
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License Number State | CA
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