Provider Demographics
NPI:1710766878
Name:ROBINSON, JENNIFER DELORES (DC)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:DELORES
Last Name:ROBINSON
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 1:2909 E 6TH ST APT A
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90814-7901
Mailing Address - Country:US
Mailing Address - Phone:314-605-8499
Mailing Address - Fax:
Practice Address - Street 1:2909 E 6TH ST APT A
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90814-7901
Practice Address - Country:US
Practice Address - Phone:314-605-8499
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-27
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35140111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor