Provider Demographics
NPI:1992892376
Name:SCECINA, MARY LYNN (DC)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:LYNN
Last Name:SCECINA
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 1:16801 VAN BUREN BLVD
Mailing Address - Street 2:SUITE D
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92504-5896
Mailing Address - Country:US
Mailing Address - Phone:951-780-8833
Mailing Address - Fax:951-780-9368
Practice Address - Street 1:16801 VAN BUREN BLVD
Practice Address - Street 2:SUITE D
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92504-5896
Practice Address - Country:US
Practice Address - Phone:951-780-8833
Practice Address - Fax:951-780-9368
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2013-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12048111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC0120480Medicare ID - Type Unspecified