MEDICARE: JESSICA JAMES DC

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	34048	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	83-1430777	OTHER	CA	OUT OF NETWORK

General Provider Information

NPI Number	:	1558848127
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA JAMES DC

Provider Business Mailing Address
First Line	:	415 N CAMDEN DR STE 204
Second Line	:
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90210-4438
Country	:	US
Telephone Number	:	310-957-9065
Fax Number	:

Provider Business Practice Location Address
First Line	:	415 N CAMDEN DR STE 204
Second Line	:
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90210-4438
Country	:	US
Telephone Number	:	310-957-9065
Fax Number	:

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

Provider Enumeration Date	:	07/25/2018
Last Update Date	:	12/07/2020

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Directions to “ JESSICA JAMES DC” Practice Location

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