Provider Demographics
NPI:1891187860
Name:JENNIFER FISHER NATUROPATHIC DOCTOR, PC
Entity Type:Organization
Organization Name:JENNIFER FISHER NATUROPATHIC DOCTOR, PC
Other - Org Name:NATUROPATHIC WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:ABERCROMBIE
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:310-926-4415
Mailing Address - Street 1:390 N SEPULVEDA BLVD
Mailing Address - Street 2:SUITE 1140
Mailing Address - City:EL SEGUNDO
Mailing Address - State:CA
Mailing Address - Zip Code:90245-4475
Mailing Address - Country:US
Mailing Address - Phone:310-926-4415
Mailing Address - Fax:310-693-5492
Practice Address - Street 1:390 N SEPULVEDA BLVD
Practice Address - Street 2:SUITE 1140
Practice Address - City:EL SEGUNDO
Practice Address - State:CA
Practice Address - Zip Code:90245-4475
Practice Address - Country:US
Practice Address - Phone:310-926-4415
Practice Address - Fax:310-693-5492
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-26
Last Update Date:2015-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAND-426175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Single Specialty