Provider Demographics
NPI:1134221948
Name:CHOCHOLATY, SHERRY LANAY (DC)
Entity type:Individual
Prefix:DR
First Name:SHERRY
Middle Name:LANAY
Last Name:CHOCHOLATY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15550 ROCKFIELD BLVD
Mailing Address - Street 2:B220
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-2720
Mailing Address - Country:US
Mailing Address - Phone:949-598-9999
Mailing Address - Fax:949-598-9990
Practice Address - Street 1:1936 CAMDEN AVENUE
Practice Address - Street 2:SUITE #2
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95124
Practice Address - Country:US
Practice Address - Phone:408-377-5777
Practice Address - Fax:408-377-6277
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-02
Last Update Date:2010-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC26857111N00000X, 111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NN0400XChiropractic ProvidersChiropractorNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0268520OtherPTAN
CADC26852OtherCHIROPRACTIC LICENSE