Provider Demographics
NPI:1740585371
Name:AUSTIN, JOESSA IRENE (DC)
Entity Type:Individual
Prefix:DR
First Name:JOESSA
Middle Name:IRENE
Last Name:AUSTIN
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 1:451 W LAMBERT RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:BREA
Mailing Address - State:CA
Mailing Address - Zip Code:92821-3922
Mailing Address - Country:US
Mailing Address - Phone:714-364-4610
Mailing Address - Fax:714-255-8066
Practice Address - Street 1:451 W LAMBERT RD
Practice Address - Street 2:SUITE 200
Practice Address - City:BREA
Practice Address - State:CA
Practice Address - Zip Code:92821-3922
Practice Address - Country:US
Practice Address - Phone:714-364-4610
Practice Address - Fax:714-255-8066
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-12
Last Update Date:2011-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5445111N00000X
CA31977111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor