Provider Demographics
NPI:1780792655
Name:LAHANN-CHIVERS, MERONEA JANINE (DC)
Entity type:Individual
Prefix:DR
First Name:MERONEA
Middle Name:JANINE
Last Name:LAHANN-CHIVERS
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 1:1343 BLOSSOM HILL RD
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95118-3801
Mailing Address - Country:US
Mailing Address - Phone:408-269-2225
Mailing Address - Fax:408-979-7878
Practice Address - Street 1:1343 BLOSSOM HILL RD
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95118-3801
Practice Address - Country:US
Practice Address - Phone:408-269-2225
Practice Address - Fax:408-979-7878
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2011-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA26757111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU87510Medicare UPIN
CADC0267570Medicare ID - Type UnspecifiedMEDICARE ID NUMBER