Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 29195 | CA |
N | 111NN0400X | Neurology | 29195 | CA |
NPI | 1376550152 |
---|---|
Provider Name | Dr. Stephen Clinton Wellens |
First Address | Walnut Creek, CA 94596-4359 |
Second Address | Walnut Creek, CA 94596-4359 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2006 |
Last Update Date | 08/07/2007 |