Provider Demographics
NPI:1619573912
Name:SEVIN, JOS (DC)
Entity Type:Individual
Prefix:DR
First Name:JOS
Middle Name:
Last Name:SEVIN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1137 ROSEWOOD WAY
Mailing Address - Street 2:
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-5635
Mailing Address - Country:US
Mailing Address - Phone:415-596-1154
Mailing Address - Fax:
Practice Address - Street 1:2416A CENTRAL AVE STE D
Practice Address - Street 2:
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94501-4516
Practice Address - Country:US
Practice Address - Phone:510-872-0200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-10
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34746111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty