Provider Demographics
NPI:1659376754
Name:SEIBERT, SHARON M (DC)
Entity Type:Individual
Prefix:DR
First Name:SHARON
Middle Name:M
Last Name:SEIBERT
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 1:12344 OAK KNOLL RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:POWAY
Mailing Address - State:CA
Mailing Address - Zip Code:92064-5347
Mailing Address - Country:US
Mailing Address - Phone:858-679-3777
Mailing Address - Fax:858-679-3797
Practice Address - Street 1:12344 OAK KNOLL RD
Practice Address - Street 2:SUITE A
Practice Address - City:POWAY
Practice Address - State:CA
Practice Address - Zip Code:92064-5347
Practice Address - Country:US
Practice Address - Phone:858-679-3777
Practice Address - Fax:858-679-3797
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-15
Last Update Date:2007-10-02
Deactivation Date:2006-03-18
Deactivation Code:
Reactivation Date:2006-03-24
Provider Licenses
StateLicense IDTaxonomies
CA21502111N00000X
AZ4977111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA330487138OtherTAX ID
CADC21502Medicare ID - Type Unspecified
CAU24371Medicare UPIN