Provider Demographics
NPI:1508187667
Name:WATSON, MARSHEA DARLENE (DC)
Entity Type:Individual
Prefix:DR
First Name:MARSHEA
Middle Name:DARLENE
Last Name:WATSON
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 1:1068 E 14TH ST STE 310
Mailing Address - Street 2:
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94577-3731
Mailing Address - Country:US
Mailing Address - Phone:510-569-5500
Mailing Address - Fax:
Practice Address - Street 1:1068 E 14TH ST
Practice Address - Street 2:
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94577-3731
Practice Address - Country:US
Practice Address - Phone:510-569-5500
Practice Address - Fax:510-569-5501
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-11
Last Update Date:2018-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31571111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor