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General NPI Number Information
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NPI Number | 1669027819
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Entity Type | Individual
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Provider Name | JADA BYRNE DACM, L.AC
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Gender | Female
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Dates
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Enumeration Date | 08/05/2019
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Last Update Date | 08/05/2019
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Provider Practice Location Address
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Address Line | 2221 PALO VERDE AVE STE 1J
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City | LONG BEACH
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State | CA
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Zip | 90815-2360
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Country | US
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Telephone | 562-239-9418
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Fax |
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Provider Business Mailing Address
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Address Line | 613 W AVENUE 28 APT 5
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City | LOS ANGELES
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State | CA
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Zip | 90065-1546
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Country | US
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Telephone | 323-316-5483
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | CA18192
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License Number State | CA
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