Provider Demographics
NPI:1790016236
Name:CECCHI, GINA MARIE (DC)
Entity Type:Individual
Prefix:DR
First Name:GINA
Middle Name:MARIE
Last Name:CECCHI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1070 PLEASANT GROVE BLVD
Mailing Address - Street 2:140B
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95678-6120
Mailing Address - Country:US
Mailing Address - Phone:916-781-6432
Mailing Address - Fax:916-782-2114
Practice Address - Street 1:1070 PLEASANT GROVE BLVD
Practice Address - Street 2:140B
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95678-6120
Practice Address - Country:US
Practice Address - Phone:916-781-6432
Practice Address - Fax:916-782-2114
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-22
Last Update Date:2010-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC24309111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor