Provider Demographics
NPI:1669706511
Name:CLISBY, DIONNE (DC)
Entity type:Individual
Prefix:DR
First Name:DIONNE
Middle Name:
Last Name:CLISBY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:DIONNE
Other - Middle Name:
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:5550 E 7TH ST
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90804-4436
Mailing Address - Country:US
Mailing Address - Phone:562-433-2177
Mailing Address - Fax:562-977-5747
Practice Address - Street 1:5550 E 7TH ST
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90804-4436
Practice Address - Country:US
Practice Address - Phone:562-433-2177
Practice Address - Fax:562-977-5747
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-24
Last Update Date:2015-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC30620111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor