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General NPI Number Information
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NPI Number | 1952743528
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Entity Type | Individual
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Provider Name | JESSICA MICHELLE GREENE ND, DC
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Gender | Female
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Dates
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Enumeration Date | 07/24/2013
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Last Update Date | 02/05/2025
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Provider Practice Location Address
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Address Line | 3211 HOLIDAY CT STE 201C
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City | LA JOLLA
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State | CA
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Zip | 92037-1810
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Country | US
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Telephone | 858-287-0623
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Fax |
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Provider Business Mailing Address
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Address Line | 3211 HOLIDAY CT STE 201C
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City | LA JOLLA
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State | CA
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Zip | 92037-1810
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Country | US
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Telephone | 858-287-0623
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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 | 111NP0017X
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Taxonomy Name | Pediatric Chiropractor
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License Number | 32688
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 175F00000X
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Taxonomy Name | Naturopath
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License Number | 938
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License Number State | CA
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