Provider Demographics
NPI:1902027477
Name:TOENJES, NICOLE ELAINE (DC)
Entity Type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:ELAINE
Last Name:TOENJES
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 1:3708 MT DIABLO BLVD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:LAFAYETTE
Mailing Address - State:CA
Mailing Address - Zip Code:94549-3631
Mailing Address - Country:US
Mailing Address - Phone:925-283-6900
Mailing Address - Fax:925-283-6981
Practice Address - Street 1:3708 MT DIABLO BLVD
Practice Address - Street 2:SUITE 120
Practice Address - City:LAFAYETTE
Practice Address - State:CA
Practice Address - Zip Code:94549-3631
Practice Address - Country:US
Practice Address - Phone:925-283-6900
Practice Address - Fax:925-283-6981
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC30200111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor