Provider Demographics
NPI:1275980427
Name:TAYEBJEE, NISREEN (DC)
Entity Type:Individual
Prefix:
First Name:NISREEN
Middle Name:
Last Name:TAYEBJEE
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 1:1905 CALLE BARCELONA STE 234
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92009-8453
Mailing Address - Country:US
Mailing Address - Phone:858-208-0710
Mailing Address - Fax:858-239-1317
Practice Address - Street 1:1905 CALLE BARCELONA STE 234
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92009-8453
Practice Address - Country:US
Practice Address - Phone:858-208-0710
Practice Address - Fax:858-239-1317
Is Sole Proprietor?:No
Enumeration Date:2016-05-18
Last Update Date:2020-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13215111N00000X
CA34078111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology
No111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX13215OtherCHIROPRACTOR LICENSE
CA34078OtherCHIROPRACTIC LICENSE