Provider Demographics
NPI:1588695837
Name:NOVAS, SESE (DC)
Entity type:Individual
Prefix:MRS
First Name:SESE
Middle Name:
Last Name:NOVAS
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 1:14340 BOLSA CHICA RD STE G
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-4868
Mailing Address - Country:US
Mailing Address - Phone:562-795-6680
Mailing Address - Fax:562-799-9575
Practice Address - Street 1:14340 BOLSA CHICA RD STE G
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-4868
Practice Address - Country:US
Practice Address - Phone:562-795-6680
Practice Address - Fax:562-799-9575
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2018-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC23082111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor