Provider Demographics
NPI:1447372628
Name:RENO, CAROLINE (DC)
Entity type:Individual
Prefix:DR
First Name:CAROLINE
Middle Name:
Last Name:RENO
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 1:714 N NAOMI ST
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505-3042
Mailing Address - Country:US
Mailing Address - Phone:818-259-4210
Mailing Address - Fax:
Practice Address - Street 1:714 N NAOMI ST
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-3042
Practice Address - Country:US
Practice Address - Phone:818-259-4210
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27951111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor