Provider Demographics
NPI:1336233873
Name:ROUZER, PATRICIA A (DC)
Entity Type:Individual
Prefix:MISS
First Name:PATRICIA
Middle Name:A
Last Name:ROUZER
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 1:621 CENTRAL AVENUE
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94043
Mailing Address - Country:US
Mailing Address - Phone:650-690-6801
Mailing Address - Fax:650-938-8939
Practice Address - Street 1:621 CENTRAL AVENUE
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94043
Practice Address - Country:US
Practice Address - Phone:650-690-6801
Practice Address - Fax:650-938-8939
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC17807111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0178070OtherBLUE SHIELD OF CALIFORNIA