1548435357 NPI number — MS. JACQUELINE JAMESON KENT D.C.

Table of content: MS. JACQUELINE JAMESON KENT D.C. (NPI 1548435357)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1548435357 NPI number — MS. JACQUELINE JAMESON KENT D.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KENT
Provider First Name:
JACQUELINE
Provider Middle Name:
JAMESON
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
D.C.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1548435357
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/23/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
655 S FLOWER ST
Provider Second Line Business Mailing Address:
368
Provider Business Mailing Address City Name:
LOS ANGELES
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90017-2805
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
213-430-9180
Provider Business Mailing Address Fax Number:
213-430-9193

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
820 34TH ST
Provider Second Line Business Practice Location Address:
100
Provider Business Practice Location Address City Name:
BAKERSFIELD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93301-2283
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-430-9180
Provider Business Practice Location Address Fax Number:
213-430-9193
Provider Enumeration Date:
04/23/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  DC21623 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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