Provider Demographics
NPI:1376550152
Name:WELLENS, STEPHEN CLINTON (DC, DACNB)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:CLINTON
Last Name:WELLENS
Suffix:
Gender:M
Credentials:DC, DACNB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1229 OAKLAND BLVD
Mailing Address - Street 2:SUITE D
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94596-4359
Mailing Address - Country:US
Mailing Address - Phone:925-935-2422
Mailing Address - Fax:925-930-0412
Practice Address - Street 1:1229 OAKLAND BLVD
Practice Address - Street 2:SUITE D
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-4359
Practice Address - Country:US
Practice Address - Phone:925-935-2422
Practice Address - Fax:925-930-0412
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA29195111N00000X, 111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered111N00000XChiropractic ProvidersChiropractor
Not Answered111NN0400XChiropractic ProvidersChiropractorNeurology