Provider Demographics
NPI:1679151591
Name:RICHARDSON DC LLC
Entity type:Organization
Organization Name:RICHARDSON DC LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MELINDA
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:VALDEZ RICHARDSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:408-440-0342
Mailing Address - Street 1:1706 WILLOW ST STE C
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95125-5216
Mailing Address - Country:US
Mailing Address - Phone:408-440-0342
Mailing Address - Fax:408-645-6470
Practice Address - Street 1:1706 WILLOW ST STE C
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95125-5216
Practice Address - Country:US
Practice Address - Phone:408-440-0342
Practice Address - Fax:408-645-6470
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-31
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service