=====================================================
General NPI Number Information
=====================================================
NPI Number | 1548302342
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JEAN DRUMMOND L.AC.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/12/2007
-----------------------------------------------------
Last Update Date | 10/14/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 22224 LA PALMA AVE STE A
-----------------------------------------------------
City | YORBA LINDA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92887-3819
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 714-692-7139
-----------------------------------------------------
Fax | 760-934-6831
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8213 E BLACKWILLOW CIR 212
-----------------------------------------------------
City | ANAHEIM
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92808-1912
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 760-914-1639
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 171100000X
-----------------------------------------------------
Taxonomy Name | Acupuncturist
-----------------------------------------------------
License Number | AC 7612
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------