Provider Demographics
NPI:1205227105
Name:GASTON, DEVON L (DC, MSC)
Entity Type:Individual
Prefix:DR
First Name:DEVON
Middle Name:L
Last Name:GASTON
Suffix:
Gender:F
Credentials:DC, MSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1741 CREEKSIDE DR
Mailing Address - Street 2:STE 100
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-3457
Mailing Address - Country:US
Mailing Address - Phone:916-984-1428
Mailing Address - Fax:916-790-8504
Practice Address - Street 1:1741 CREEKSIDE DR
Practice Address - Street 2:STE 100
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-3457
Practice Address - Country:US
Practice Address - Phone:916-984-4128
Practice Address - Fax:916-790-8504
Is Sole Proprietor?:No
Enumeration Date:2015-02-12
Last Update Date:2019-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33152111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor