Provider Demographics
NPI:1750667499
Name:TAPIA, JEANETT (DC)
Entity Type:Individual
Prefix:DR
First Name:JEANETT
Middle Name:
Last Name:TAPIA
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 1:2425 CAMINO DEL RIO SOUTH
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108
Mailing Address - Country:US
Mailing Address - Phone:619-756-7510
Mailing Address - Fax:619-393-0179
Practice Address - Street 1:2425 CAMINO DEL RIO SOUTH
Practice Address - Street 2:SUITE 100
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108
Practice Address - Country:US
Practice Address - Phone:619-756-7510
Practice Address - Fax:619-393-0179
Is Sole Proprietor?:No
Enumeration Date:2011-10-26
Last Update Date:2015-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31907111N00000X
CADC31907111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor