Provider Demographics
NPI:1265673487
Name:JENSEN, JOCELYN J (ND)
Entity Type:Individual
Prefix:DR
First Name:JOCELYN
Middle Name:J
Last Name:JENSEN
Suffix:
Gender:F
Credentials:ND
Other - Prefix:DR
Other - First Name:JONCI
Other - Middle Name:
Other - Last Name:JENSEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ND
Mailing Address - Street 1:4106 SORRENTO VALLEY BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92121-1407
Mailing Address - Country:US
Mailing Address - Phone:858-246-9700
Mailing Address - Fax:
Practice Address - Street 1:4106 SORRENTO VALLEY BLVD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-1407
Practice Address - Country:US
Practice Address - Phone:858-246-9700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-18
Last Update Date:2013-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ12-1320175F00000X
CAND606175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ12-1320OtherNATUROPATHIC MEDICAL LICENSE
CAND606OtherNATUROPATHIC DOCTOR LICENSE