Provider Demographics
NPI:1861494767
Name:GAUSSOIN, JANET BOYLE (DC)
Entity Type:Individual
Prefix:DR
First Name:JANET
Middle Name:BOYLE
Last Name:GAUSSOIN
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 1:555 W. TEFFT ST.
Mailing Address - Street 2:SUITE #2
Mailing Address - City:NIPOMO
Mailing Address - State:CA
Mailing Address - Zip Code:93444-7909
Mailing Address - Country:US
Mailing Address - Phone:805-931-0300
Mailing Address - Fax:805-931-0337
Practice Address - Street 1:555 W. TEFFT ST.
Practice Address - Street 2:SUITE #2
Practice Address - City:NIPOMO
Practice Address - State:CA
Practice Address - Zip Code:93444-7909
Practice Address - Country:US
Practice Address - Phone:805-931-0300
Practice Address - Fax:805-931-0337
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-11
Last Update Date:2020-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20193111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U11192Medicare UPIN
DC20193Medicare ID - Type Unspecified