Provider Demographics
NPI:1821544305
Name:HAMMER-CODD, JENNIFER
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:HAMMER-CODD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:709 PETALUMA BLVD N
Mailing Address - Street 2:
Mailing Address - City:PETALUMA
Mailing Address - State:CA
Mailing Address - Zip Code:94952-2106
Mailing Address - Country:US
Mailing Address - Phone:707-763-0564
Mailing Address - Fax:
Practice Address - Street 1:709 PETALUMA BLVD N
Practice Address - Street 2:
Practice Address - City:PETALUMA
Practice Address - State:CA
Practice Address - Zip Code:94952-2106
Practice Address - Country:US
Practice Address - Phone:707-763-0564
Practice Address - Fax:707-763-8982
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-25
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33675111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor