Provider Demographics
NPI:1548302342
Name:DRUMMOND, JEAN (LAC)
Entity type:Individual
Prefix:MS
First Name:JEAN
Middle Name:
Last Name:DRUMMOND
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8213 E BLACKWILLOW CIR
Mailing Address - Street 2:212
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92808-1912
Mailing Address - Country:US
Mailing Address - Phone:760-914-1639
Mailing Address - Fax:
Practice Address - Street 1:22224 LA PALMA AVE
Practice Address - Street 2:STE A
Practice Address - City:YORBA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92887-3819
Practice Address - Country:US
Practice Address - Phone:714-692-7139
Practice Address - Fax:760-934-6831
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2015-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 7612171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist