Provider Demographics
NPI:1790729200
Name:NICE, VERONICA F (DC)
Entity Type:Individual
Prefix:DR
First Name:VERONICA
Middle Name:F
Last Name:NICE
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 1:1757 S COAST HWY
Mailing Address - Street 2:
Mailing Address - City:LAGUNA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92651-3229
Mailing Address - Country:US
Mailing Address - Phone:949-494-7233
Mailing Address - Fax:949-376-6884
Practice Address - Street 1:1757 S COAST HWY
Practice Address - Street 2:
Practice Address - City:LAGUNA BEACH
Practice Address - State:CA
Practice Address - Zip Code:92651-3229
Practice Address - Country:US
Practice Address - Phone:949-494-7233
Practice Address - Fax:949-376-6884
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC22791111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU72254Medicare UPIN