Provider Demographics
NPI:1922875756
Name:GEORGY, JACQUELINE EMILE ALPHONSE (DC)
Entity Type:Individual
Prefix:DR
First Name:JACQUELINE
Middle Name:EMILE ALPHONSE
Last Name:GEORGY
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 1:21416 LAKER CT
Mailing Address - Street 2:
Mailing Address - City:CHATSWORTH
Mailing Address - State:CA
Mailing Address - Zip Code:91311-1497
Mailing Address - Country:US
Mailing Address - Phone:818-818-4932
Mailing Address - Fax:
Practice Address - Street 1:27965 SMYTH DR STE 101
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-6017
Practice Address - Country:US
Practice Address - Phone:661-288-0022
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-12
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC36710111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor