Provider Demographics
NPI:1649877119
Name:PHILLIPS, VICTORIA (DC)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:PHILLIPS
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 1:7220 AVENIDA ENCINAS STE 206
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92011-4661
Mailing Address - Country:US
Mailing Address - Phone:760-942-9505
Mailing Address - Fax:
Practice Address - Street 1:7220 AVENIDA ENCINAS STE 206
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92011-4661
Practice Address - Country:US
Practice Address - Phone:760-942-9505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-07
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34839111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor