Provider Demographics
NPI:1497840169
Name:MITCHELL, ALICIA ARLYNE (DC)
Entity Type:Individual
Prefix:DR
First Name:ALICIA
Middle Name:ARLYNE
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:ALICIA
Other - Middle Name:ARLYNE
Other - Last Name:MAYFIELD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:2920 VEDA STREET
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001
Mailing Address - Country:US
Mailing Address - Phone:530-223-9377
Mailing Address - Fax:530-223-9177
Practice Address - Street 1:2920 VEDA STREET
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001
Practice Address - Country:US
Practice Address - Phone:530-223-9377
Practice Address - Fax:530-223-9177
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2008-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC28400111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0284000Medicare PIN