Provider Demographics
NPI:1104027739
Name:FRAUENGLASS, JUDITH (DC)
Entity Type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:
Last Name:FRAUENGLASS
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 1:915 IRVING ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94122-2206
Mailing Address - Country:US
Mailing Address - Phone:415-665-0202
Mailing Address - Fax:
Practice Address - Street 1:915 IRVING ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94122-2206
Practice Address - Country:US
Practice Address - Phone:415-665-0202
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18799111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor