Provider Demographics
NPI:1306986948
Name:FINNELL, STEVEN WAYNE (DC)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:WAYNE
Last Name:FINNELL
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 1:193 BLUE RAVINE RD
Mailing Address - Street 2:SUITE #245
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-4756
Mailing Address - Country:US
Mailing Address - Phone:916-989-1014
Mailing Address - Fax:916-989-1461
Practice Address - Street 1:193 BLUE RAVINE RD
Practice Address - Street 2:SUITE #245
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-4756
Practice Address - Country:US
Practice Address - Phone:916-989-1014
Practice Address - Fax:916-989-1461
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2008-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23517111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA23517OtherCA LICENSE NUMBER
CAZZZ55590ZOtherBLUE SHIELD GROUP NUMBER
CAZZZ55590ZOtherBLUE SHIELD GROUP NUMBER
CADC0235170Medicare ID - Type Unspecified