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General NPI Number Information
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NPI Number | 1982747259
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Entity Type | Individual
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Provider Name | JONICE MAE OWEN D.C.
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Gender | Female
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Dates
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Enumeration Date | 02/15/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 5901 CHRISTIE AVE STE 307
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City | EMERYVILLE
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State | CA
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Zip | 94608-1934
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Country | US
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Telephone | 510-652-4532
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Fax | 510-652-6204
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Provider Business Mailing Address
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Address Line | 5901 CHRISTIE AVE STE 307
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City | EMERYVILLE
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State | CA
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Zip | 94608-1934
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Country | US
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Telephone | 510-652-4532
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Fax | 510-652-6204
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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 | 111NX0800X
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Taxonomy Name | Orthopedic Chiropractor
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License Number | DC18903
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License Number State | CA
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