Provider Demographics
NPI:1578645560
Name:HERTA CHIROPRACTIC INC.
Entity type:Organization
Organization Name:HERTA CHIROPRACTIC INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:L
Authorized Official - Last Name:HERTA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:661-288-0022
Mailing Address - Street 1:28640 HIGH RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91390-5743
Mailing Address - Country:US
Mailing Address - Phone:661-288-0022
Mailing Address - Fax:661-288-2030
Practice Address - Street 1:27965 SMYTH DR STE 101
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-6017
Practice Address - Country:US
Practice Address - Phone:661-288-0022
Practice Address - Fax:661-288-2030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-19
Last Update Date:2025-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30274111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty