Provider Demographics
NPI:1255632949
Name:JARCHOW, MOLLY (ND, LM)
Entity type:Individual
Prefix:
First Name:MOLLY
Middle Name:
Last Name:JARCHOW
Suffix:
Gender:F
Credentials:ND, LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2128 PICO BLVD
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90405-1718
Mailing Address - Country:US
Mailing Address - Phone:213-534-6373
Mailing Address - Fax:213-769-6119
Practice Address - Street 1:2128 PICO BLVD
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90405-1718
Practice Address - Country:US
Practice Address - Phone:213-534-6373
Practice Address - Fax:213-769-6119
Is Sole Proprietor?:No
Enumeration Date:2010-11-11
Last Update Date:2016-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAND-437175F00000X
CALM290176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No176B00000XOther Service ProvidersMidwife