Provider Demographics
NPI:1710248976
Name:ALBERTI, JENNIFER
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:ALBERTI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1811 WALNUT ST
Mailing Address - Street 2:APT 4
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80302-5540
Mailing Address - Country:US
Mailing Address - Phone:617-592-9927
Mailing Address - Fax:
Practice Address - Street 1:1811 WALNUT ST
Practice Address - Street 2:APT 4
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80302-5540
Practice Address - Country:US
Practice Address - Phone:617-592-9927
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-05
Last Update Date:2012-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1572171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist