Provider Demographics
NPI:1982811261
Name:SIMPSON, LANI (DC)
Entity Type:Individual
Prefix:DR
First Name:LANI
Middle Name:
Last Name:SIMPSON
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 1:1517 ADDISON ST
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94703-1401
Mailing Address - Country:US
Mailing Address - Phone:510-644-3038
Mailing Address - Fax:510-898-0934
Practice Address - Street 1:1517 ADDISON ST.
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94703-1401
Practice Address - Country:US
Practice Address - Phone:510-644-3038
Practice Address - Fax:510-898-0934
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16864111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition