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General NPI Number Information
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NPI Number | 1023433968
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Entity Type | Individual
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Provider Name | JESSICA GRICHY D.C
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Gender | Female
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Dates
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Enumeration Date | 03/02/2014
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Last Update Date | 03/02/2014
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Provider Practice Location Address
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Address Line | 14622 VENTURA BLVD STE 205
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City | SHERMAN OAKS
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State | CA
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Zip | 91403-3600
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Country | US
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Telephone | 213-948-0705
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Fax |
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Provider Business Mailing Address
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Address Line | 12830 BURBANK BLVD # 309
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City | VALLEY VILLAGE
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State | CA
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Zip | 91607-1442
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Country | US
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Telephone | 213-948-0705
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 32878
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License Number State | CA
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