Provider Demographics
NPI:1013080100
Name:HAWES, JENNIFER L (DC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:L
Last Name:HAWES
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 1:14 WILLIAMSBURG LANE
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926
Mailing Address - Country:US
Mailing Address - Phone:530-345-2544
Mailing Address - Fax:530-345-2076
Practice Address - Street 1:14 WILLIAMSBURG LANE
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926
Practice Address - Country:US
Practice Address - Phone:530-345-2544
Practice Address - Fax:530-345-2076
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACA24807111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0248070Medicare UPIN