Provider Demographics
NPI:1275176174
Name:SERPICO, ABIGAIL COLLEEN-BOORMAN (DC)
Entity Type:Individual
Prefix:DR
First Name:ABIGAIL
Middle Name:COLLEEN-BOORMAN
Last Name:SERPICO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:ABIGAIL
Other - Middle Name:COLLEEN
Other - Last Name:BOORMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:2511 GARDEN RD # C-11
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-5330
Mailing Address - Country:US
Mailing Address - Phone:831-899-5900
Mailing Address - Fax:831-899-5859
Practice Address - Street 1:2511 GARDEN RD # C-11
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-5330
Practice Address - Country:US
Practice Address - Phone:831-899-5900
Practice Address - Fax:831-899-5859
Is Sole Proprietor?:No
Enumeration Date:2019-10-23
Last Update Date:2020-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34606111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor