Provider Demographics
NPI:1508966334
Name:SIENES, CHRISTOPHER P (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:P
Last Name:SIENES
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:665 NEW YORK RANCH RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:JACKSON
Mailing Address - State:CA
Mailing Address - Zip Code:95642-9331
Mailing Address - Country:US
Mailing Address - Phone:209-223-2225
Mailing Address - Fax:209-223-2976
Practice Address - Street 1:665 NEW YORK RANCH RD
Practice Address - Street 2:SUITE 1
Practice Address - City:JACKSON
Practice Address - State:CA
Practice Address - Zip Code:95642-9331
Practice Address - Country:US
Practice Address - Phone:209-223-2225
Practice Address - Fax:209-223-2976
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC182610111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0182610Medicare ID - Type Unspecified
CAT06665Medicare UPIN