DR. JACQUELINE CONNOLLY (NPI# 1043456494) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043456494 |
| Entity Type | Individual |
| Full Name | DR. JACQUELINE CONNOLLY |
| Credential | D.C. |
| Practice Address |
4560 Admiralty Way Suite 252 Marina Del Rey CA 90292-5423 |
| Mailing Address |
4712 Admiralty Way 179 Marina Del Rey CA 90292-6905 |
| Practice Telephone | 3103064828 |
| Mailing Telephone | 3103064828 |
| Enumeration Date | 2009-01-06 |
| Last Update Date | 2011-05-31 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 30739 | CA | Chiropractic Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699218339 | Jacqueline Connolly | Occupational Therapist | 49 Walnut St, Bldg. 3, Wellesley, MA 02481-2117 | 2016-11-29 |
| 1760509400 | Jacqueline Connolly | Physical Therapy Assistant | 380 Washington Ave, Roosevelt, NY 11575-1845 | 2007-03-26 |
| 1457384273 | Jacqueline M Connolly | Nurse Practitioner | 819 S Salina St, Syracuse, NY 13202-3527 | 2006-07-07 |
| Street Address |
4560 ADMIRALTY WAY SUITE 252 |
| City | MARINA DEL REY |
| State | CA |
| Zip Code | 90292-5423 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225021272 | Helen Marie Sanderson | Dentist | 4560 Admiralty Way, Suite #250, Marina Del Rey, CA 90292-5423 | 2005-08-24 |
| 1437520020 | Regents University of California Los Angeles | Durable Medical Equipment & Medical Supplies | 4560 Admiralty Way, Suite 100, Marina Del Rey, CA 90292-5423 | 2015-10-08 |
| 1811376452 | Regents of The University of California | Clinic/Center | 4560 Admiralty Way, 100, Marina Del Rey, CA 90292-5423 | 2015-05-28 |
| 1245625847 | Rosita Tan | Dentist | 4560 Admiralty Way, Ste 350, Marina Del Rey, CA 90292-5423 | 2015-03-31 |
| 1730596818 | Agim Gashi Dpm Inc | Podiatrist | 4560 Admiralty Way, Suite 351, Marina Del Rey, CA 90292-5423 | 2014-07-21 |
| 1114347986 | Justin Perez | Plastic Surgery | 4560 Admiralty Way, Marina Del Rey, CA 90292-5423 | 2014-04-21 |
| 1912330952 | Julie Gould | Obstetrics & Gynecology | 4560 Admiralty Way, Suite 105, Marina Del Rey, CA 90292-5423 | 2013-08-13 |
| 1831451004 | Rosita D. Tan Dmd, Inc | Durable Medical Equipment & Medical Supplies | 4560 Admiralty Way, Suite 350, Marina Del Rey, CA 90292-5423 | 2012-06-13 |
| 1760756860 | Dr. Jamie A. Lipeles, A Professional Medical Corporation | Obstetrics & Gynecology | 4560 Admiralty Way, #105, Marina Del Rey, CA 90292-5423 | 2012-03-07 |
| 1780998542 | R. Paul St. Amand, M.d., Inc. | Internal Medicine | 4560 Admiralty Way, Ste. 355, Marina Del Rey, CA 90292-5423 | 2010-08-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972142420 | Katy Kleinberg | Physical Therapist | 4820 Lincoln Blvd., Marina Del Rey, CA 90292 | 2020-01-02 |
| 1568028330 | Kylie Nakamine | Physical Therapist | 4820 Lincoln Bld, Marina Del Rey, CA 90292 | 2019-05-16 |
| 1033627807 | Kareema Nasouf | Social Worker | 578 Washington Blvd. #815, Marina Del Rey, CA 90292 | 2018-01-16 |
| 1861916611 | Jaqueline Berenice Higbee | Behavior Technician | 13428 Maxella Ave Apt 913, Marina Del Rey, CA 90292 | 2017-08-02 |
| 1063942696 | Luis Albert Japngie | Chiropractor | 13816 Bora Bora Way, A-109, Marina Del Rey, CA 90292 | 2017-06-15 |
| 1427509082 | Melissa Dowling | Nurse Anesthetist, Certified Registered | 4750 Lincoln Blvd Apt 477, Marina Del Rey, CA 90292 | 2016-10-19 |
| 1578932950 | Gratto Aquatic Rehab | Clinic/Center | 13160 Mindanao Way Ste. 308, Marina Del Ray, CA 90292 | 2015-09-16 |
| 1285018309 | Reed Chiropractic & Wellness Center A Professional Corporation | Chiropractor | 4207 Del Rey Ave., Marina Del Rey, CA 90292 | 2015-07-18 |
| 1083990725 | James J Kim | Pharmacist | 4009 Lincoln Blvd., Walgreens, Marina Del Rey, CA 90292 | 2011-10-26 |
| 1689957805 | Medbil, LLC | Anesthesiology | 1024 Oxford Ave., Marina Del Rey, CA 90292 | 2011-09-23 |
| Find all providers in zip 90292 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063942696 | Luis Albert Japngie | Chiropractor | 13816 Bora Bora Way, A-109, Marina Del Rey, CA 90292 | 2017-06-15 |
| 1285018309 | Reed Chiropractic & Wellness Center A Professional Corporation | Chiropractor | 4207 Del Rey Ave., Marina Del Rey, CA 90292 | 2015-07-18 |
| 1619372513 | Shamim Mashhadi | Chiropractor | 3221 Carter Ave Unit 303, Marina Del Rey, CA 90292-4958 | 2014-11-04 |
| 1114329588 | Gabriel Altman | Chiropractor | 3701 Via Dolce, Marina Del Rey, CA 90292-5243 | 2014-09-17 |
| 1194156109 | Jenny M. Stofer | Chiropractor | 4284 Lincoln Blvd, Marina Del Rey, CA 90292-5654 | 2013-12-02 |
| 1104097179 | Aria Yarmand | Chiropractor | 13400 Washington Blvd, Suite 105, Marina Del Rey, CA 90292-5656 | 2008-03-18 |
| 1063548386 | David Michael Reed | Chiropractor | 13356 Beach Ave, Marina Del Rey, CA 90292-5622 | 2007-02-23 |
| 1508904244 | Cergei Walter Klishevich | Chiropractor | 4560 Admiralty Way Ste 302, Marina Del Rey, CA 90292-5426 | 2007-02-02 |
| 1427130939 | Greg V Fecht | Chiropractor | 4519 Admiralty Way Ste C, Marina Del Rey, CA 90292-5455 | 2006-10-20 |
| 1750461596 | Michael Billauer | Chiropractor | 2901 Washington Blvd, Marina Del Rey, CA 90292-5546 | 2006-10-16 |
| Find all providers in MARINA DEL REY | ||||
| City | MARINA DEL REY |
| Zip Code | 90292 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.