Healthcare Provider Details

I. General information

NPI: 1285972232
Provider Name (Legal Business Name): JENNIFER REINER, DC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2013
Last Update Date: 01/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9972 SCRIPPS RANCH BLVD
SAN DIEGO CA
92131-1825
US

IV. Provider business mailing address

3639 MIDWAY DR SUITE B286
SAN DIEGO CA
92110-5254
US

V. Phone/Fax

Practice location:
  • Phone: 858-488-3597
  • Fax: 858-746-4041
Mailing address:
  • Phone: 858-488-3597
  • Fax: 858-746-4041

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License NumberDC30168
License Number StateCA

VIII. Authorized Official

Name: DR. JENNIFER ELIZABETH REINER
Title or Position: CHIROPRACTOR
Credential: DC
Phone: 858-488-3597