Provider Demographics
NPI:1417181041
Name:HORTON, JENNIFER GARCIA (LAC DAOM)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:GARCIA
Last Name:HORTON
Suffix:
Gender:F
Credentials:LAC DAOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2208 RHODA WAY
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-2029
Mailing Address - Country:US
Mailing Address - Phone:916-706-1582
Mailing Address - Fax:
Practice Address - Street 1:2208 RHODA WAY
Practice Address - Street 2:
Practice Address - City:RANCHO CORDOVA
Practice Address - State:CA
Practice Address - Zip Code:95670-2029
Practice Address - Country:US
Practice Address - Phone:916-706-1582
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-11
Last Update Date:2009-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 9732171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist