Provider Demographics
NPI:1023433968
Name:GRICHY, JESSICA (DC)
Entity type:Individual
Prefix:MISS
First Name:JESSICA
Middle Name:
Last Name:GRICHY
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 1:12830 BURBANK BLVD
Mailing Address - Street 2:# 309
Mailing Address - City:VALLEY VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91607-1442
Mailing Address - Country:US
Mailing Address - Phone:213-948-0705
Mailing Address - Fax:
Practice Address - Street 1:14622 VENTURA BLVD
Practice Address - Street 2:STE 205
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403-3600
Practice Address - Country:US
Practice Address - Phone:213-948-0705
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-02
Last Update Date:2014-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32878111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor