Provider Demographics
NPI:1427174531
Name:STEWART-WELSH, JEANNINE LEE (DC)
Entity type:Individual
Prefix:DR
First Name:JEANNINE
Middle Name:LEE
Last Name:STEWART-WELSH
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 1:5826 E BONNYVIEW RD
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001-4536
Mailing Address - Country:US
Mailing Address - Phone:949-675-8820
Mailing Address - Fax:530-215-3970
Practice Address - Street 1:824 W 15TH ST
Practice Address - Street 2:#4
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-6110
Practice Address - Country:US
Practice Address - Phone:949-675-8820
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2022-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA016542111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor