Provider Demographics
NPI:1245320746
Name:WATKINS, ALEXANDRA LYN (DC)
Entity type:Individual
Prefix:DR
First Name:ALEXANDRA
Middle Name:LYN
Last Name:WATKINS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:930 ALHAMBRA BLVD
Mailing Address - Street 2:60
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95816-4426
Mailing Address - Country:US
Mailing Address - Phone:916-441-2501
Mailing Address - Fax:916-441-3168
Practice Address - Street 1:930 ALHAMBRA BLVD
Practice Address - Street 2:60
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-4426
Practice Address - Country:US
Practice Address - Phone:916-441-2501
Practice Address - Fax:916-441-3168
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACA15426111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU96995Medicare UPIN