Provider Demographics
NPI:1144031030
Name:JAMES, JENNIFER LAUREN (LAC, BSN)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LAUREN
Last Name:JAMES
Suffix:
Gender:F
Credentials:LAC, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:646 WESTHAVEN DR N
Mailing Address - Street 2:
Mailing Address - City:TRINIDAD
Mailing Address - State:CA
Mailing Address - Zip Code:95570-9685
Mailing Address - Country:US
Mailing Address - Phone:847-772-9223
Mailing Address - Fax:
Practice Address - Street 1:646 WESTHAVEN DR N
Practice Address - Street 2:
Practice Address - City:TRINIDAD
Practice Address - State:CA
Practice Address - Zip Code:95570-9685
Practice Address - Country:US
Practice Address - Phone:847-772-9223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-18
Last Update Date:2025-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC20253171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist