Provider Demographics
NPI:1831106582
Name:INJERD, LETAYE VIVIAN (DC)
Entity Type:Individual
Prefix:
First Name:LETAYE
Middle Name:VIVIAN
Last Name:INJERD
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 1:2371 WASHINGTON AVE.
Mailing Address - Street 2:STE #D
Mailing Address - City:OROVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95966
Mailing Address - Country:US
Mailing Address - Phone:530-533-9102
Mailing Address - Fax:530-533-9102
Practice Address - Street 1:2371 WASHINGTON AVE STE D
Practice Address - Street 2:
Practice Address - City:OROVILLE
Practice Address - State:CA
Practice Address - Zip Code:95966-5466
Practice Address - Country:US
Practice Address - Phone:530-533-9102
Practice Address - Fax:530-533-9102
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC0105130111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor