Provider Demographics
NPI:1003116609
Name:ABERCROMBIE, JENNIFER (ND)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:
Last Name:ABERCROMBIE
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:FISHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ND
Mailing Address - Street 1:390 N SEPULVEDA BLVD
Mailing Address - Street 2:SUITE 1140
Mailing Address - City:EL SEGUNDO
Mailing Address - State:CA
Mailing Address - Zip Code:90245-4475
Mailing Address - Country:US
Mailing Address - Phone:310-926-4415
Mailing Address - Fax:310-693-5492
Practice Address - Street 1:390 N SEPULVEDA BLVD
Practice Address - Street 2:SUITE 1140
Practice Address - City:EL SEGUNDO
Practice Address - State:CA
Practice Address - Zip Code:90245-4475
Practice Address - Country:US
Practice Address - Phone:310-926-4415
Practice Address - Fax:619-342-4828
Is Sole Proprietor?:No
Enumeration Date:2010-10-28
Last Update Date:2015-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAND-426175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath