Provider Demographics
NPI:1558447011
Name:DAY, JUDY ALICE (DC)
Entity Type:Individual
Prefix:
First Name:JUDY
Middle Name:ALICE
Last Name:DAY
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 1:450 E 14TH STREET
Mailing Address - Street 2:
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94577-1810
Mailing Address - Country:US
Mailing Address - Phone:510-568-1724
Mailing Address - Fax:510-568-5027
Practice Address - Street 1:450 E 14TH STREET
Practice Address - Street 2:
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94577-1810
Practice Address - Country:US
Practice Address - Phone:510-568-1724
Practice Address - Fax:510-568-5027
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20156111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U64791Medicare UPIN
DC0201560Medicare ID - Type Unspecified