Provider Demographics
NPI:1720306483
Name:WARNOCK, JENIFER (DC)
Entity Type:Individual
Prefix:DR
First Name:JENIFER
Middle Name:
Last Name:WARNOCK
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 1:2620 LARKSPUR LN STE N
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96002-1043
Mailing Address - Country:US
Mailing Address - Phone:530-605-3810
Mailing Address - Fax:530-605-3820
Practice Address - Street 1:2620 LARKSPUR LN STE N
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96002-1043
Practice Address - Country:US
Practice Address - Phone:530-605-3810
Practice Address - Fax:530-605-3820
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-05
Last Update Date:2010-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA29945111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor