DR. DANIELLE CUSTODE (NPI# 1295924983) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295924983 |
| Entity Type | Individual |
| Full Name | DR. DANIELLE CUSTODE |
| Credential | D.C. |
| Practice Address |
3400 Table Mesa Dr Suite 201 Boulder CO 80305-5869 |
| Practice Telephone | 3034999442 |
| Practice Fax Number | 3034948678 |
| Mailing Telephone | 3034999442 |
| Mailing Fax Number | 3034948678 |
| Enumeration Date | 2007-10-17 |
| Last Update Date | 2008-02-29 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 5900 | CO | Chiropractic Providers |
| Street Address |
3400 TABLE MESA DR SUITE 201 |
| City | BOULDER |
| State | CO |
| Zip Code | 80305-5869 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417998501 | Larry Eric Frieder | Chiropractor | 3400 Table Mesa Dr, #201, Boulder, CO 80305 | 2006-06-09 |
| 1124519426 | Sarah Elizabeth Gibson | Counselor | 3400 Table Mesa Dr, Boulder, CO 80305-5869 | 2018-05-22 |
| 1386006989 | Chrisana Olson, Ph.d., Pllc | Psychologist | 3400 Table Mesa Dr, Suite 203, Boulder, CO 80305-5869 | 2016-03-22 |
| 1871998898 | Nicolas Desmet | Massage Therapist | 3400 Table Mesa Dr, Suite 203, Boulder, CO 80305-5869 | 2014-11-03 |
| 1144625906 | Sara Lindblom | Massage Therapist | 3400 Table Mesa Dr, Suite 203, Boulder, CO 80305-5869 | 2014-10-22 |
| 1811391410 | Daniela Jaramillo | Massage Therapist | 3400 Table Mesa Dr, Suite 203, Boulder, CO 80305-5869 | 2014-10-10 |
| 1881011229 | Caitlin Dygulski | Massage Therapist | 3400 Table Mesa Dr, Suite 203, Boulder, CO 80305-5869 | 2014-03-24 |
| 1841614344 | Chanel Jost | Massage Therapist | 3400 Table Mesa Dr, Suite 203, Boulder, CO 80305-5869 | 2014-02-05 |
| 1699198598 | Susan E Butler | Massage Therapist | 3400 Table Mesa Dr, 203, Boulder, CO 80305-5869 | 2014-01-28 |
| 1295166593 | Aqui Mizrahi | Acupuncturist | 3400 Table Mesa Dr, Suite 205, Boulder, CO 80305-5869 | 2013-12-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538698923 | Carian Mclean | Registered Nurse | 1013 Berea Dr, Boulder, CO 80305 | 2017-06-08 |
| 1548629439 | Kimberly Norquist | Dental Hygienist | 661 S. Broadway St, Boulder, CO 80305 | 2016-02-19 |
| 1871981266 | Kathleen Anne Stone | Registered Nurse | 3680 Silver Plume Lane, Boulder, CO 80305 | 2015-01-07 |
| 1104235779 | Joyce Larson | Marriage & Family Therapist | 1190 S Lashley Ln, Boulder, CO 80305 | 2014-08-07 |
| 1982035788 | Virginia Pleasants Vandenbergh | Counselor | 4760 Ludlow St, Boulder, CO 80305 | 2013-12-03 |
| 1790992550 | Jasjit Singh Gill | Pharmacist | The Apothecary Pharmacy - University of Colorado, 350 Broadway Ste. 50, Boulder, CO 80305 | 2007-05-17 |
| 1477768299 | Stephen W Laycock | Dentist | 4150 Darley Ave., Suite 7, Boulder, CO 80305 | 2007-05-14 |
| 1871614560 | Steven Leslie Buffer | Dentist | 385 Broadway St, Boulder, CO 80305 | 2007-04-02 |
| 1801927793 | Jeffrey Dann | Acupuncturist | 3400 Table Mesa Drive, Ste. 205, Boulder, CO 80305 | 2007-03-09 |
| 1235292145 | Pharmaca Integrative Pharmacy | Exclusive Provider Organization | 645 South Boulder, Boulder, CO 80305 | 2006-12-19 |
| Find all providers in zip 80305 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811508369 | Haak Chiropractic LLC | Chiropractor | 6666 Gunpark Dr Ste 100, Boulder, CO 80301-3396 | 2020-08-10 |
| 1720605256 | Evol.v Chiropractic LLC | Chiropractor | 2401 Broadway #208, Boulder, CO 80304 | 2020-07-01 |
| 1386268779 | Amy Katelyn Putrus-schnell | Chiropractor | 2013 Walnut St # 1, Boulder, CO 80302-4485 | 2020-06-02 |
| 1568008910 | Navit Ariel Zukerman | Chiropractor | 2401 Broadway St # 208, Boulder, CO 80304-4108 | 2019-11-20 |
| 1508416934 | Lisa Gail Raskin | Chiropractor | 2299 Pearl St Ste 204, Boulder, CO 80302-4670 | 2019-09-17 |
| 1477108918 | Carolyn Wojtusiak | Chiropractor | 1800 30th St Ste 219, Boulder, CO 80301-1026 | 2019-08-01 |
| 1073086567 | Justin Russell Willcoxson | Chiropractor | 2525 Arapahoe Ave Unit C2, Boulder, CO 80302-6724 | 2019-01-07 |
| 1265911994 | Ryan Keith Marchman | Chiropractor | 1727 15th St Ste 100b, Boulder, CO 80302-6346 | 2018-08-13 |
| 1255819751 | Henry Zaremba | Chiropractor | 4840 Riverbend Rd Ste 100, Boulder, CO 80301-2633 | 2018-08-06 |
| 1437645231 | Joshua B Luitjohan | Chiropractor | 2625 28th St Ste 100, Boulder, CO 80301-1263 | 2018-07-03 |
| Find all providers in BOULDER | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.