Provider Demographics
NPI:1841235751
Name:NOHRDEN, RICHARD CHARLES (DC)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:CHARLES
Last Name:NOHRDEN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:390 S GREEN VALLEY RD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:WATSONVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95076-3077
Mailing Address - Country:US
Mailing Address - Phone:831-728-1866
Mailing Address - Fax:831-728-1851
Practice Address - Street 1:390 S GREEN VALLEY RD
Practice Address - Street 2:SUITE 4
Practice Address - City:WATSONVILLE
Practice Address - State:CA
Practice Address - Zip Code:95076-3077
Practice Address - Country:US
Practice Address - Phone:831-728-1866
Practice Address - Fax:831-728-1851
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 23340111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU57406Medicare UPIN
CADC0233400Medicare ID - Type Unspecified