Provider Demographics
NPI:1003048398
Name:STEPUTIS RYAN, JEANETTE S (DC)
Entity Type:Individual
Prefix:DR
First Name:JEANETTE
Middle Name:S
Last Name:STEPUTIS RYAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:JEANETTE
Other - Middle Name:S
Other - Last Name:RYAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:910 EMBURY ST
Mailing Address - Street 2:
Mailing Address - City:PACIFIC PALISADES
Mailing Address - State:CA
Mailing Address - Zip Code:90272-3810
Mailing Address - Country:US
Mailing Address - Phone:310-395-3653
Mailing Address - Fax:
Practice Address - Street 1:1448 15TH ST STE 105
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-2756
Practice Address - Country:US
Practice Address - Phone:310-395-3653
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-20
Last Update Date:2009-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 23696111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition