Provider Demographics
NPI:1508954272
Name:HJELMSTAD, JARED P (DC)
Entity Type:Individual
Prefix:DR
First Name:JARED
Middle Name:P
Last Name:HJELMSTAD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29377 RANCHO CALIFORNIA RD
Mailing Address - Street 2:#106
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92591
Mailing Address - Country:US
Mailing Address - Phone:951-676-8686
Mailing Address - Fax:951-676-5158
Practice Address - Street 1:29377 RANCHO CALIFORNIA RD
Practice Address - Street 2:#106
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92591
Practice Address - Country:US
Practice Address - Phone:951-676-8686
Practice Address - Fax:951-676-5158
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC22006111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA22006OtherSTATE LIC NUMBER
CADC0220060OtherBLUE SHIELD
CADC0220060OtherBLUE CROSS
CADC0220060OtherBLUE CROSS
CAU34521Medicare UPIN