Provider Demographics
NPI:1730284035
Name:CADAVA, KRISTY (DC)
Entity Type:Individual
Prefix:DR
First Name:KRISTY
Middle Name:
Last Name:CADAVA
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 1:1676 PALM AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92154-1027
Mailing Address - Country:US
Mailing Address - Phone:619-423-3217
Mailing Address - Fax:619-423-8619
Practice Address - Street 1:1676 PALM AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92154-1027
Practice Address - Country:US
Practice Address - Phone:619-423-3217
Practice Address - Fax:619-423-8619
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-13
Last Update Date:2015-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22976111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC22976Medicare UPIN