Provider Demographics
NPI:1154595247
Name:COLOMA, JANICE R (DC)
Entity type:Individual
Prefix:DR
First Name:JANICE
Middle Name:R
Last Name:COLOMA
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 1:1080 MINGO WAY
Mailing Address - Street 2:
Mailing Address - City:LATHROP
Mailing Address - State:CA
Mailing Address - Zip Code:95330-9353
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1341 W ROBINHOOD DR STE C2
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95207-5516
Practice Address - Country:US
Practice Address - Phone:209-817-6035
Practice Address - Fax:209-952-3718
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-18
Last Update Date:2011-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA29726111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor