Provider Demographics
NPI:1225333511
Name:LANZAROTTA, SUZETTE T (DC)
Entity Type:Individual
Prefix:DR
First Name:SUZETTE
Middle Name:T
Last Name:LANZAROTTA
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 1294
Mailing Address - Street 2:
Mailing Address - City:NEWCASTLE
Mailing Address - State:CA
Mailing Address - Zip Code:95658-1294
Mailing Address - Country:US
Mailing Address - Phone:530-889-9359
Mailing Address - Fax:
Practice Address - Street 1:5130 COMMONS DR
Practice Address - Street 2:STE 101
Practice Address - City:ROCKLIN
Practice Address - State:CA
Practice Address - Zip Code:95677-3923
Practice Address - Country:US
Practice Address - Phone:530-889-9359
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-18
Last Update Date:2018-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC16129111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC16129OtherBOARD OF CHIROPRACTIC EXAMINERS