Provider Demographics
NPI:1013947852
Name:LANSER, WENDY RUTH (DC)
Entity Type:Individual
Prefix:DR
First Name:WENDY
Middle Name:RUTH
Last Name:LANSER
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 1:990 W FREMONT AVE
Mailing Address - Street 2:SUITE P
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94087-3021
Mailing Address - Country:US
Mailing Address - Phone:408-245-5454
Mailing Address - Fax:408-245-5656
Practice Address - Street 1:990 W FREMONT AVE
Practice Address - Street 2:SUITE P
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94087-3021
Practice Address - Country:US
Practice Address - Phone:408-245-5454
Practice Address - Fax:408-245-5656
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2011-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA26085111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA770546315Medicare ID - Type Unspecified