Provider Demographics
NPI:1215229893
Name:SUAREZ, JANUARY DIANE (DC)
Entity Type:Individual
Prefix:DR
First Name:JANUARY
Middle Name:DIANE
Last Name:SUAREZ
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 1:7290 NAVAJO RD STE 106
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92119-1631
Mailing Address - Country:US
Mailing Address - Phone:858-342-3646
Mailing Address - Fax:
Practice Address - Street 1:7290 NAVAJO RD STE 106
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92119-1631
Practice Address - Country:US
Practice Address - Phone:858-342-3646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-13
Last Update Date:2015-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA29805111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor