Provider Demographics
NPI:1023697984
Name:OLIVEIRA, NATHAN (DC)
Entity type:Individual
Prefix:
First Name:NATHAN
Middle Name:
Last Name:OLIVEIRA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1717 34TH ST
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95816-7039
Mailing Address - Country:US
Mailing Address - Phone:916-794-5372
Mailing Address - Fax:
Practice Address - Street 1:5363 H ST STE A
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95819-3555
Practice Address - Country:US
Practice Address - Phone:916-794-5372
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-06
Last Update Date:2022-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC35040111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor