Provider Demographics
NPI:1043547490
Name:LEMON, JENNA M (DC)
Entity Type:Individual
Prefix:DR
First Name:JENNA
Middle Name:M
Last Name:LEMON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2623 E FOOTHILL BLVD
Mailing Address - Street 2:105
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91107-3466
Mailing Address - Country:US
Mailing Address - Phone:626-796-2639
Mailing Address - Fax:626-796-2673
Practice Address - Street 1:2623 E FOOTHILL BLVD
Practice Address - Street 2:105
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91107-3466
Practice Address - Country:US
Practice Address - Phone:626-796-2639
Practice Address - Fax:626-796-2673
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-05
Last Update Date:2009-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30225111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor