Provider Demographics
NPI:1609924331
Name:SCOFIELD, JUNE CELESE (DC)
Entity Type:Individual
Prefix:
First Name:JUNE
Middle Name:CELESE
Last Name:SCOFIELD
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 1:941 SPRING ST
Mailing Address - Street 2:SUITE 5
Mailing Address - City:PLACERVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95667-4546
Mailing Address - Country:US
Mailing Address - Phone:530-622-9131
Mailing Address - Fax:530-622-9138
Practice Address - Street 1:941 SPRING ST
Practice Address - Street 2:SUITE 5
Practice Address - City:PLACERVILLE
Practice Address - State:CA
Practice Address - Zip Code:95667-4546
Practice Address - Country:US
Practice Address - Phone:530-622-9131
Practice Address - Fax:530-622-9138
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 14755111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0147550Medicare PIN