Provider Demographics
NPI:1174998744
Name:TAKAHASHI, NORIE (DC)
Entity type:Individual
Prefix:
First Name:NORIE
Middle Name:
Last Name:TAKAHASHI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:NORIE
Other - Middle Name:TAKAHASHI
Other - Last Name:LANG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2614 CASTLE HAVEN CT
Mailing Address - Street 2:
Mailing Address - City:TRACY
Mailing Address - State:CA
Mailing Address - Zip Code:95377-8620
Mailing Address - Country:US
Mailing Address - Phone:209-597-8880
Mailing Address - Fax:
Practice Address - Street 1:227 E 11TH ST
Practice Address - Street 2:
Practice Address - City:TRACY
Practice Address - State:CA
Practice Address - Zip Code:95376-4015
Practice Address - Country:US
Practice Address - Phone:209-597-8880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-08
Last Update Date:2015-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA334428111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor