Provider Demographics
NPI:1275542193
Name:HALVORSON, PAULA (DC)
Entity Type:Individual
Prefix:DR
First Name:PAULA
Middle Name:
Last Name:HALVORSON
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 1:31333 TEMECULA PARKWAY
Mailing Address - Street 2:SUITE 140
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92592
Mailing Address - Country:US
Mailing Address - Phone:951-483-2007
Mailing Address - Fax:951-483-2008
Practice Address - Street 1:31333 TEMECULA PARKWAY
Practice Address - Street 2:SUITE 140
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92592
Practice Address - Country:US
Practice Address - Phone:951-483-2007
Practice Address - Fax:951-483-2008
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19679111N00000X
NC1708111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890843TMedicaid
NC2454032Medicare ID - Type Unspecified
NC890843TMedicaid