Provider Demographics
NPI:1164548137
Name:CARTER, JENNIFER JIANG (LAC PHD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:JIANG
Last Name:CARTER
Suffix:
Gender:F
Credentials:LAC PHD
Other - Prefix:DR
Other - First Name:JENNIFER
Other - Middle Name:D
Other - Last Name:JIANG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LAC PHD
Mailing Address - Street 1:741 E CHAPMAN AVE
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92866-1620
Mailing Address - Country:US
Mailing Address - Phone:714-532-6699
Mailing Address - Fax:714-532-3999
Practice Address - Street 1:741 E CHAPMAN AVE
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92866-1620
Practice Address - Country:US
Practice Address - Phone:714-532-6699
Practice Address - Fax:714-692-3999
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC1232171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist