Provider Demographics
NPI:1225301518
Name:ROBERTSON, DARCI (DC)
Entity Type:Individual
Prefix:DR
First Name:DARCI
Middle Name:
Last Name:ROBERTSON
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:PO BOX 835
Mailing Address - Street 2:
Mailing Address - City:LOS ALAMOS
Mailing Address - State:CA
Mailing Address - Zip Code:93440-0835
Mailing Address - Country:US
Mailing Address - Phone:831-588-7425
Mailing Address - Fax:805-344-3493
Practice Address - Street 1:2027 VILLAGE LN
Practice Address - Street 2:SUITE 202
Practice Address - City:SOLVANG
Practice Address - State:CA
Practice Address - Zip Code:93463-2283
Practice Address - Country:US
Practice Address - Phone:805-688-9426
Practice Address - Fax:805-688-2076
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-16
Last Update Date:2012-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32206111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician