Provider Demographics
NPI:1841365327
Name:PADEN, JENEANNE V (LAC)
Entity type:Individual
Prefix:
First Name:JENEANNE
Middle Name:V
Last Name:PADEN
Suffix:
Gender:F
Credentials:LAC
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Mailing Address - Street 1:11515 EL CAMINO REAL
Mailing Address - Street 2:STE 160
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92130-3038
Mailing Address - Country:US
Mailing Address - Phone:858-792-7611
Mailing Address - Fax:858-356-0412
Practice Address - Street 1:8950 VILLA LA JOLLA DR
Practice Address - Street 2:C-117
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-1714
Practice Address - Country:US
Practice Address - Phone:858-546-1530
Practice Address - Fax:858-546-1575
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2009-03-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAAC6731171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist