Provider Demographics
NPI:1427102391
Name:PADGETT, LINETTE BOOKER (DC)
Entity type:Individual
Prefix:
First Name:LINETTE
Middle Name:BOOKER
Last Name:PADGETT
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 1:702 SUTTER STREET
Mailing Address - Street 2:SUITE J
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-2554
Mailing Address - Country:US
Mailing Address - Phone:916-985-6400
Mailing Address - Fax:916-985-2403
Practice Address - Street 1:702 SUTTER STREET
Practice Address - Street 2:SUITE J
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-2554
Practice Address - Country:US
Practice Address - Phone:916-985-6400
Practice Address - Fax:916-985-2403
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC0122410111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0122410Medicare ID - Type Unspecified
T04687Medicare UPIN