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General NPI Number Information
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NPI Number | 1992186183
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Entity Type | Organization
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Legal Business Name | JENSEN SPORTS CHIROPRACTIC INC.
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Dates
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Enumeration Date | 06/12/2015
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Last Update Date | 12/29/2015
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Provider Practice Location Address
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Address Line | 1000 PASEO CAMARILLO #118
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City | CAMARILLO
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State | CA
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Zip | 93010-6021
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Country | US
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Telephone | 805-419-4234
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Fax |
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Provider Business Mailing Address
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Address Line | 669 CALLE PORTILLA
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City | CAMARILLO
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State | CA
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Zip | 93010-1862
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | STEVEN JENSEN
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Credential | DC
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Telephone | 805-419-4234
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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 | DC17932
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License Number State | CA
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