Provider Demographics
NPI:1386792703
Name:FORSTER, JENNIFER L (DC)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:L
Last Name:FORSTER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2435 FOREST AVE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-1595
Mailing Address - Country:US
Mailing Address - Phone:408-244-0727
Mailing Address - Fax:408-865-9475
Practice Address - Street 1:2435 FOREST AVE
Practice Address - Street 2:SUITE 110
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-1595
Practice Address - Country:US
Practice Address - Phone:408-244-0727
Practice Address - Fax:408-865-9475
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2014-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC29406111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0294060Medicare PIN
CADC0294060Medicare UPIN