Provider Demographics
NPI:1275756926
Name:CARINO, JENNIFER M (LAC, MSTCM)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:M
Last Name:CARINO
Suffix:
Gender:F
Credentials:LAC, MSTCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:946 LEAVENWORTH ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-4913
Mailing Address - Country:US
Mailing Address - Phone:415-377-8655
Mailing Address - Fax:415-346-7658
Practice Address - Street 1:946 LEAVENWORTH ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-4913
Practice Address - Country:US
Practice Address - Phone:415-377-8655
Practice Address - Fax:415-346-7658
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC8293171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist