Provider Demographics
NPI:1487366407
Name:LABIT, JENNIFER MARTINEZ (DC)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:MARTINEZ
Last Name:LABIT
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 1:1010 16TH ST APT 629
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94107-3780
Mailing Address - Country:US
Mailing Address - Phone:650-556-3001
Mailing Address - Fax:
Practice Address - Street 1:359 BEL MARIN KEYS BLVD STE 10
Practice Address - Street 2:
Practice Address - City:NOVATO
Practice Address - State:CA
Practice Address - Zip Code:94949-5637
Practice Address - Country:US
Practice Address - Phone:415-295-7227
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-21
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC34942111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAY2102075OtherCALIFORNIA DRIVER'S LICENSE