Basic Information
Provider Information
NPI: 1194116509
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GARFOLA
FirstName: VICKI
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: DC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 1848
Address2:  
City: NOVATO
State: CA
PostalCode: 949481848
CountryCode: US
TelephoneNumber: 4158927560
FaxNumber: 4158927509
Practice Location
Address1: THREE EMBARCADERO CENTER
Address2: LOBBY LEVEL
City: SAN FRANCISCO
State: CA
PostalCode: 94111
CountryCode: US
TelephoneNumber: 4154952225
FaxNumber: 4154952228
Other Information
ProviderEnumerationDate: 02/07/2015
LastUpdateDate: 06/26/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
111N00000X33175CAY Chiropractic ProvidersChiropractor 

No ID Information.


Home