Provider Demographics
NPI:1730110172
Name:FAULKNER, DELLA L (DC)
Entity Type:Individual
Prefix:DR
First Name:DELLA
Middle Name:L
Last Name:FAULKNER
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 1:3249 MT DIABLO CT
Mailing Address - Street 2:101- B
Mailing Address - City:LAFAYETTE
Mailing Address - State:CA
Mailing Address - Zip Code:94549-4084
Mailing Address - Country:US
Mailing Address - Phone:925-937-2225
Mailing Address - Fax:925-937-6865
Practice Address - Street 1:3249 MT DIABLO CT
Practice Address - Street 2:101- B
Practice Address - City:LAFAYETTE
Practice Address - State:CA
Practice Address - Zip Code:94549-4084
Practice Address - Country:US
Practice Address - Phone:925-937-2225
Practice Address - Fax:925-937-6865
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2009-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19622111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor