Provider Demographics
NPI:1457661506
Name:ROMA, ANN MAKAYA (DC)
Entity Type:Individual
Prefix:MS
First Name:ANN
Middle Name:MAKAYA
Last Name:ROMA
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 1:6144A HIGHWAY 9
Mailing Address - Street 2:
Mailing Address - City:FELTON
Mailing Address - State:CA
Mailing Address - Zip Code:95018-9704
Mailing Address - Country:US
Mailing Address - Phone:831-335-7798
Mailing Address - Fax:831-335-7798
Practice Address - Street 1:6144A HIGHWAY 9
Practice Address - Street 2:
Practice Address - City:FELTON
Practice Address - State:CA
Practice Address - Zip Code:95018-9704
Practice Address - Country:US
Practice Address - Phone:831-335-7798
Practice Address - Fax:831-335-7798
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-07
Last Update Date:2010-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18937111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor