=====================================================
General NPI Number Information
=====================================================
NPI Number | 1700987997
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PLACER CHRIPRACTIC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/26/2006
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2221 SUNSET BLVD STE 103
-----------------------------------------------------
City | ROCKLIN
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95765-4784
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 916-435-1522
-----------------------------------------------------
Fax | 916-435-2216
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2221 SUNSET BLVD STE 103
-----------------------------------------------------
City | ROCKLIN
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95765-4784
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 916-435-1522
-----------------------------------------------------
Fax | 916-435-2216
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DR. AND OWNER
-----------------------------------------------------
Name | DR. RONALD SHERROD
-----------------------------------------------------
Credential | DC
-----------------------------------------------------
Telephone | 916-435-1522
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | DC25533
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | DC27169
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------