Healthcare Provider Details

I. General information

NPI: 1518800531
Provider Name (Legal Business Name): JENNIFER MRAOVIC DACM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2026
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

849 ETCHEVERRY ST
RAMONA CA
92065-3113
US

IV. Provider business mailing address

849 ETCHEVERRY ST
RAMONA CA
92065-3113
US

V. Phone/Fax

Practice location:
  • Phone: 847-638-2446
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number20608
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: