MEDICARE: DR. JERI ANDERSON D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	DC18303	CA

General Provider Information

NPI Number	:	1457359101
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JERI ANDERSON D.C.

Provider Business Mailing Address
First Line	:	9500 MICRON AVE
Second Line	:	SUITE 108
City	:	SACRAMENTO
State	:	CA
Zip	:	95827-2617
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9500 MICRON AVE
Second Line	:	SUITE 108
City	:	SACRAMENTO
State	:	CA
Zip	:	95827-2617
Country	:	US
Telephone Number	:	916-368-1600
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	06/16/2014

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