Healthcare Provider Details

I. General information

NPI: 1366200370
Provider Name (Legal Business Name): DR JENNIFER ESCARCEGA DC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2024
Last Update Date: 04/02/2024
Certification Date: 04/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5310 HOMESTEAD RD NE STE 202A
ALBUQUERQUE NM
87110-1524
US

IV. Provider business mailing address

5310 HOMESTEAD RD NE STE 202A
ALBUQUERQUE NM
87110-1524
US

V. Phone/Fax

Practice location:
  • Phone: 505-292-2226
  • Fax: 505-292-3181
Mailing address:
  • Phone: 505-292-2226
  • Fax: 505-292-3181

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER ESCARCEGA
Title or Position: OWNER
Credential: DC
Phone: 954-800-5421