Provider Demographics
NPI:1891031837
Name:GUNDERMAN, JENNIFER KAY BAHR (ND)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:KAY BAHR
Last Name:GUNDERMAN
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3633 CAMINO DEL RIO S STE 103
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-4047
Mailing Address - Country:US
Mailing Address - Phone:858-461-8121
Mailing Address - Fax:818-659-3175
Practice Address - Street 1:3633 CAMINO DEL RIO S STE 103
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-4047
Practice Address - Country:US
Practice Address - Phone:858-461-8121
Practice Address - Fax:818-659-3175
Is Sole Proprietor?:No
Enumeration Date:2012-12-19
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAND-548175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath