Provider Demographics
NPI:1265654446
Name:DESAULNIERS, SYLVAIN A (DC)
Entity Type:Individual
Prefix:
First Name:SYLVAIN
Middle Name:A
Last Name:DESAULNIERS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:SYL
Other - Middle Name:
Other - Last Name:DESAULNIERS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:451 PARKFAIR DR STE 4
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95864-7249
Mailing Address - Country:US
Mailing Address - Phone:916-484-6882
Mailing Address - Fax:916-914-2464
Practice Address - Street 1:451 PARKFAIR DR STE 4
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95864-7249
Practice Address - Country:US
Practice Address - Phone:916-484-6882
Practice Address - Fax:916-914-2464
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2019-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC18015111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor