Provider Demographics
NPI:1942261284
Name:JONES, ROSIELEE ARTEMESE (DC)
Entity Type:Individual
Prefix:
First Name:ROSIELEE
Middle Name:ARTEMESE
Last Name:JONES
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 1:16555 SHERMAN WAY
Mailing Address - Street 2:SUITE C
Mailing Address - City:LAKE BALBOA
Mailing Address - State:CA
Mailing Address - Zip Code:91406-3781
Mailing Address - Country:US
Mailing Address - Phone:818-782-0022
Mailing Address - Fax:818-782-0052
Practice Address - Street 1:16555 SHERMAN WAY
Practice Address - Street 2:SUITE C
Practice Address - City:LAKE BALBOA
Practice Address - State:CA
Practice Address - Zip Code:91406-3781
Practice Address - Country:US
Practice Address - Phone:818-782-0022
Practice Address - Fax:818-782-0052
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-28
Last Update Date:2011-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC13562111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAT17536Medicare UPIN