Provider Demographics
NPI:1518998806
Name:WEDDLE, SHEILA A (DC)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:A
Last Name:WEDDLE
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 1:3816 WOODRUFF AVE # 210
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90808-2147
Mailing Address - Country:US
Mailing Address - Phone:562-653-4079
Mailing Address - Fax:
Practice Address - Street 1:3816 WOODRUFF AVE # 210
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90808-2147
Practice Address - Country:US
Practice Address - Phone:562-653-4079
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2022-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27189111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU95321Medicare UPIN