Provider Demographics
NPI:1083748859
Name:JENSEN AND JENSEN DCS
Entity Type:Organization
Organization Name:JENSEN AND JENSEN DCS
Other - Org Name:SHASTA SPINE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JENS
Authorized Official - Middle Name:OLE
Authorized Official - Last Name:JENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:530-241-2798
Mailing Address - Street 1:1115 EUREKA WAY
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001-0816
Mailing Address - Country:US
Mailing Address - Phone:530-241-2798
Mailing Address - Fax:530-241-3066
Practice Address - Street 1:1115 EUREKA WAY
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-0816
Practice Address - Country:US
Practice Address - Phone:530-241-2798
Practice Address - Fax:530-241-3066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC19853, DC19769111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ55850ZOtherBLUE SHIELD OF CA PROVIDE