Provider Demographics
NPI:1568532448
Name:LEVY, VERONICA OLKOWSKI (DC)
Entity Type:Individual
Prefix:DR
First Name:VERONICA
Middle Name:OLKOWSKI
Last Name:LEVY
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 1:712 D ST STE D
Mailing Address - Street 2:
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94901-3705
Mailing Address - Country:US
Mailing Address - Phone:415-485-6999
Mailing Address - Fax:415-485-0153
Practice Address - Street 1:712 D ST
Practice Address - Street 2:STE D
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94901-3709
Practice Address - Country:US
Practice Address - Phone:415-485-6999
Practice Address - Fax:415-485-0153
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16196111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0161960Medicare ID - Type UnspecifiedPROVIDER NUMBER