Provider Demographics
NPI:1275580144
Name:ASAKURA, DEBRA T (DC)
Entity Type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:T
Last Name:ASAKURA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:DEBRA
Other - Middle Name:T
Other - Last Name:ELLIOTT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:1315 HOT SPRINGS WAY STE 101
Mailing Address - Street 2:
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92081-7878
Mailing Address - Country:US
Mailing Address - Phone:760-419-0002
Mailing Address - Fax:844-315-8759
Practice Address - Street 1:1315 HOT SPRINGS WAY STE 101
Practice Address - Street 2:
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92081-7878
Practice Address - Country:US
Practice Address - Phone:760-419-0002
Practice Address - Fax:844-315-8759
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-27
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21223111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC21223OtherSTATE LICENSE NUMBER