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Individual
DR. SHELLEY D WISE
Active
Individual
DR. SHELLEY D WISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.C.
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
R1318520818
CA
111N00000X
Chiropractor
DC20443
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
770308423
BLUE CROSS
CA
01
—
7703084230006
CIGNA
CA
01
—
DC0204430
BLUE SHIELD
CA
Enumeration date
05/24/2005
Last updated
09/10/2018
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