Provider Demographics
NPI:1053444810
Name:SEPULVEDA, GLADYS MINET (DC)
Entity type:Individual
Prefix:DR
First Name:GLADYS
Middle Name:MINET
Last Name:SEPULVEDA
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 1:1006 HILL ST.
Mailing Address - Street 2:APT. # 1010
Mailing Address - City:BELMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94402-5263
Mailing Address - Country:US
Mailing Address - Phone:510-978-3743
Mailing Address - Fax:
Practice Address - Street 1:767 INDUSTRIAL RD
Practice Address - Street 2:
Practice Address - City:SAN CARLOS
Practice Address - State:CA
Practice Address - Zip Code:94070-3310
Practice Address - Country:US
Practice Address - Phone:415-547-0566
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2014-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA29868111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor