Provider Demographics
NPI:1679878680
Name:BERRY, CHRISTY M (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTY
Middle Name:M
Last Name:BERRY
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 1:13844 ALTON PKWY
Mailing Address - Street 2:SUITE 138
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-1620
Mailing Address - Country:US
Mailing Address - Phone:949-813-3505
Mailing Address - Fax:
Practice Address - Street 1:13844 ALTON PKWY
Practice Address - Street 2:SUITE 138
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-1620
Practice Address - Country:US
Practice Address - Phone:949-813-3505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-21
Last Update Date:2013-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA29886111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition