Healthcare Provider Details

I. General information

NPI: 1467397547
Provider Name (Legal Business Name): BRITTNEE JACK DC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/23/2026
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4551 N BANNER DR APT 1
LONG BEACH CA
90807-1869
US

IV. Provider business mailing address

4551 N BANNER DR APT 1
LONG BEACH CA
90807-1869
US

V. Phone/Fax

Practice location:
  • Phone: 562-972-0528
  • Fax:
Mailing address:
  • Phone: 562-972-0528
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC37594
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: