Provider Demographics
NPI:1851521579
Name:GARRIDO, JOHANNES F (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHANNES
Middle Name:F
Last Name:GARRIDO
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 1:438 W BEVERLY PL
Mailing Address - Street 2:SUITE 101
Mailing Address - City:TRACY
Mailing Address - State:CA
Mailing Address - Zip Code:95376-3011
Mailing Address - Country:US
Mailing Address - Phone:209-832-9221
Mailing Address - Fax:209-832-9297
Practice Address - Street 1:438 W BEVERLY PL
Practice Address - Street 2:SUITE 101
Practice Address - City:TRACY
Practice Address - State:CA
Practice Address - Zip Code:95376-3011
Practice Address - Country:US
Practice Address - Phone:209-832-9221
Practice Address - Fax:209-832-9297
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-15
Last Update Date:2016-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30707111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor