Provider Demographics
NPI:1942593223
Name:CARAUDDO, JENNIFER MARQUERITE (DC)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:MARQUERITE
Last Name:CARAUDDO
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 1:880 E CAMPBELL AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:CAMPBELL
Mailing Address - State:CA
Mailing Address - Zip Code:95008-2341
Mailing Address - Country:US
Mailing Address - Phone:408-371-6003
Mailing Address - Fax:
Practice Address - Street 1:880 E CAMPBELL AVE STE 103
Practice Address - Street 2:
Practice Address - City:CAMPBELL
Practice Address - State:CA
Practice Address - Zip Code:95008-2341
Practice Address - Country:US
Practice Address - Phone:408-371-6003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-19
Last Update Date:2011-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 31819111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor