Provider Demographics
NPI:1720270440
Name:ZEGLEN, JENNIFER HENDERSON (ND)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:HENDERSON
Last Name:ZEGLEN
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1991 VILLAGE PARK WAY
Mailing Address - Street 2:SUITE 206A
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-1994
Mailing Address - Country:US
Mailing Address - Phone:760-216-8769
Mailing Address - Fax:
Practice Address - Street 1:1991 VILLAGE PARK WAY
Practice Address - Street 2:SUITE 206A
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-1994
Practice Address - Country:US
Practice Address - Phone:760-216-8769
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-16
Last Update Date:2007-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAND-183175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath