Provider Demographics
NPI:1811142961
Name:RICHINS, DEAN V (DC)
Entity type:Individual
Prefix:
First Name:DEAN
Middle Name:V
Last Name:RICHINS
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:PO BOX 485
Mailing Address - Street 2:
Mailing Address - City:GRIDLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95948-0485
Mailing Address - Country:US
Mailing Address - Phone:530-846-4056
Mailing Address - Fax:530-846-5889
Practice Address - Street 1:639 VERMONT ST
Practice Address - Street 2:
Practice Address - City:GRIDLEY
Practice Address - State:CA
Practice Address - Zip Code:95948-2442
Practice Address - Country:US
Practice Address - Phone:530-846-4056
Practice Address - Fax:530-846-5889
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-17
Last Update Date:2008-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC0102250111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0102250Medicare PIN