Provider Demographics
NPI:1285201368
Name:EDGINTON, BRIANNA LOUISE (DC)
Entity Type:Individual
Prefix:
First Name:BRIANNA
Middle Name:LOUISE
Last Name:EDGINTON
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 1:18255 SABINI CT
Mailing Address - Street 2:
Mailing Address - City:MORGAN HILL
Mailing Address - State:CA
Mailing Address - Zip Code:95037-3423
Mailing Address - Country:US
Mailing Address - Phone:503-801-4230
Mailing Address - Fax:
Practice Address - Street 1:18525 SUTTER BLVD STE 200
Practice Address - Street 2:
Practice Address - City:MORGAN HILL
Practice Address - State:CA
Practice Address - Zip Code:95037-2899
Practice Address - Country:US
Practice Address - Phone:408-779-3565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-08
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34811111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician