Provider Demographics
NPI:1922672955
Name:JENNIFER E. ROSS, L.AC.
Entity Type:Organization
Organization Name:JENNIFER E. ROSS, L.AC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-738-7323
Mailing Address - Street 1:946 MACARTHUR BLVD APT 1
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94610-3800
Mailing Address - Country:US
Mailing Address - Phone:707-738-7323
Mailing Address - Fax:510-550-5749
Practice Address - Street 1:403 49TH ST STE E
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-2101
Practice Address - Country:US
Practice Address - Phone:510-629-9456
Practice Address - Fax:510-550-5749
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-14
Last Update Date:2021-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty