Provider Demographics
NPI:1508086232
Name:DEABUENO, JOREEN GRIEGO (DC)
Entity Type:Individual
Prefix:DR
First Name:JOREEN
Middle Name:GRIEGO
Last Name:DEABUENO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 DWIGHT WAY STE D
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94704-2639
Mailing Address - Country:US
Mailing Address - Phone:510-540-4189
Mailing Address - Fax:510-843-0228
Practice Address - Street 1:2000 DWIGHT WAY STE D
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94704-2639
Practice Address - Country:US
Practice Address - Phone:510-540-4189
Practice Address - Fax:510-843-0228
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18077111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor