Provider Demographics
NPI:1912108549
Name:JANET B. GAUSSOIN
Entity type:Organization
Organization Name:JANET B. GAUSSOIN
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JANET
Authorized Official - Middle Name:BOYLE
Authorized Official - Last Name:GAUSSOIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:805-931-0300
Mailing Address - Street 1:671 W TEFFT ST
Mailing Address - Street 2:SUITE #7
Mailing Address - City:NIPOMO
Mailing Address - State:CA
Mailing Address - Zip Code:93444-8988
Mailing Address - Country:US
Mailing Address - Phone:805-931-0300
Mailing Address - Fax:805-931-0337
Practice Address - Street 1:671 W TEFFT ST
Practice Address - Street 2:SUITE #7
Practice Address - City:NIPOMO
Practice Address - State:CA
Practice Address - Zip Code:93444-8988
Practice Address - Country:US
Practice Address - Phone:805-931-0300
Practice Address - Fax:805-931-0337
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-30
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC20193111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty