Provider Demographics
NPI:1538242920
Name:TURNER, WENDI (D C)
Entity type:Individual
Prefix:DR
First Name:WENDI
Middle Name:
Last Name:TURNER
Suffix:
Gender:F
Credentials:D C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:640 MISSION AVE
Mailing Address - Street 2:STE A
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94901-3266
Mailing Address - Country:US
Mailing Address - Phone:415-485-0110
Mailing Address - Fax:
Practice Address - Street 1:640 MISSION AVE
Practice Address - Street 2:STE A
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94901-3266
Practice Address - Country:US
Practice Address - Phone:415-485-0110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28439111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU94219Medicare UPIN