Provider Demographics
NPI:1598413031
Name:KUSHNER, ANN CHALOTTE (DC)
Entity Type:Individual
Prefix:DR
First Name:ANN
Middle Name:CHALOTTE
Last Name:KUSHNER
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 1:225 UNION AVE APT 110
Mailing Address - Street 2:
Mailing Address - City:CAMPBELL
Mailing Address - State:CA
Mailing Address - Zip Code:95008-3582
Mailing Address - Country:US
Mailing Address - Phone:520-559-5784
Mailing Address - Fax:
Practice Address - Street 1:1101 S WINCHESTER BLVD STE D138
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-3914
Practice Address - Country:US
Practice Address - Phone:408-394-0288
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-14
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33003111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor