Provider Demographics
NPI:1538752738
Name:VIEGAS, JADE ELIZABETH (DC)
Entity type:Individual
Prefix:
First Name:JADE
Middle Name:ELIZABETH
Last Name:VIEGAS
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 1:1225 VIENNA DR SPC 47
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94089-1808
Mailing Address - Country:US
Mailing Address - Phone:403-669-1210
Mailing Address - Fax:
Practice Address - Street 1:177 BOVET RD STE 150
Practice Address - Street 2:
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94402-3117
Practice Address - Country:US
Practice Address - Phone:650-375-2545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-18
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35008111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor