Provider Demographics
NPI:1902934920
Name:WEBER, STRAWBERRY G (DC)
Entity type:Individual
Prefix:
First Name:STRAWBERRY
Middle Name:G
Last Name:WEBER
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 1:658 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:RED BLUFF
Mailing Address - State:CA
Mailing Address - Zip Code:96080-3321
Mailing Address - Country:US
Mailing Address - Phone:530-527-0263
Mailing Address - Fax:530-527-0202
Practice Address - Street 1:658 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:RED BLUFF
Practice Address - State:CA
Practice Address - Zip Code:96080-3321
Practice Address - Country:US
Practice Address - Phone:530-527-0263
Practice Address - Fax:530-527-0202
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2015-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC26168111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA202222168OtherTAX ID
CA202222168OtherTAX ID