Provider Demographics
NPI:1942437553
Name:MASON, CASSANDRA M (DC)
Entity type:Individual
Prefix:DR
First Name:CASSANDRA
Middle Name:M
Last Name:MASON
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 1:1407 S B ST
Mailing Address - Street 2:
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94402-2433
Mailing Address - Country:US
Mailing Address - Phone:650-571-1122
Mailing Address - Fax:650-571-1265
Practice Address - Street 1:1407 S B ST
Practice Address - Street 2:
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94402-2433
Practice Address - Country:US
Practice Address - Phone:650-571-1122
Practice Address - Fax:650-571-1265
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-22
Last Update Date:2013-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 30770111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACR337AMedicare PIN