Provider Demographics
NPI:1215033444
Name:ANDREONI, LAURIE J (DC)
Entity Type:Individual
Prefix:
First Name:LAURIE
Middle Name:J
Last Name:ANDREONI
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 1:7940 FOLSOM AUBURN RD
Mailing Address - Street 2:
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-1600
Mailing Address - Country:US
Mailing Address - Phone:916-987-9991
Mailing Address - Fax:916-987-9904
Practice Address - Street 1:7940 FOLSOM AUBURN RD
Practice Address - Street 2:
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-1600
Practice Address - Country:US
Practice Address - Phone:916-987-9991
Practice Address - Fax:916-987-9904
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2009-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA024787111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA270543852OtherCORPORATE TAX ID FOR ANDREONI CHIROPRACTIC, INC.
CA270543852OtherCORPORATE TAX ID FOR ANDREONI CHIROPRACTIC, INC.