Provider Demographics
NPI:1275187965
Name:MENDELSOHN, DEANNA MARGARET (DC)
Entity Type:Individual
Prefix:DR
First Name:DEANNA
Middle Name:MARGARET
Last Name:MENDELSOHN
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 1:3530 LOCHINVAR AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95051-5108
Mailing Address - Country:US
Mailing Address - Phone:408-905-6483
Mailing Address - Fax:
Practice Address - Street 1:3530 LOCHINVAR AVE
Practice Address - Street 2:
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95051-5108
Practice Address - Country:US
Practice Address - Phone:925-385-6466
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-31
Last Update Date:2019-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34572111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor