Provider Demographics
NPI:1851586556
Name:PEDLEY, JENNIFER JEAN (DC)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:JEAN
Last Name:PEDLEY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:JEAN
Other - Last Name:PEDLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:940 FLORENCE RD
Mailing Address - Street 2:
Mailing Address - City:LIVERMORE
Mailing Address - State:CA
Mailing Address - Zip Code:94550-5541
Mailing Address - Country:US
Mailing Address - Phone:312-218-1358
Mailing Address - Fax:
Practice Address - Street 1:700 EAST REDLANDS BLVD
Practice Address - Street 2:STE U
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-5541
Practice Address - Country:US
Practice Address - Phone:909-353-9348
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-06
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038010539111NR0200X
OH3977111NR0200X
NY010597111NR0200X
CA31467111NR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0200XChiropractic ProvidersChiropractorRadiology