Provider Demographics
NPI:1447755590
Name:DECOSSE, MARIA (DC)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:
Last Name:DECOSSE
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 1:530 SEARLS AVE STE C
Mailing Address - Street 2:
Mailing Address - City:NEVADA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95959-3048
Mailing Address - Country:US
Mailing Address - Phone:530-648-0668
Mailing Address - Fax:530-687-8261
Practice Address - Street 1:530 SEARLS AVE STE C
Practice Address - Street 2:
Practice Address - City:NEVADA CITY
Practice Address - State:CA
Practice Address - Zip Code:95959-3048
Practice Address - Country:US
Practice Address - Phone:530-648-0668
Practice Address - Fax:530-687-8261
Is Sole Proprietor?:No
Enumeration Date:2018-03-29
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33890111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor