Provider Demographics
NPI:1457529638
Name:HEDAYAT, NICK NADER (DC)
Entity Type:Individual
Prefix:
First Name:NICK
Middle Name:NADER
Last Name:HEDAYAT
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 1:1399 YGNACIO VALLEY RD
Mailing Address - Street 2:SUITE #26
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-2884
Mailing Address - Country:US
Mailing Address - Phone:510-407-0878
Mailing Address - Fax:
Practice Address - Street 1:1399 YGNACIO VALLEY RD.
Practice Address - Street 2:SUITE #26
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598
Practice Address - Country:US
Practice Address - Phone:510-407-0878
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-11
Last Update Date:2015-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC26200111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor