Active NPI
Jennifer M Watters, D.C., L.AC.
- Chiropractor
- Santa Monica, CA
National Provider Identifier
1912133919
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 31258
- Practice address
- 710 Wilshire Blvd Ste 314
Santa Monica, CA 90401-1724 - Phone
- (310) 977-5779
- NPI assigned
- Jun 4, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 31258 | CA | Primary |
| Acupuncturist | 171100000X | 13668 | CA |
Addresses
Primary practice location
710 Wilshire Blvd Ste 314
Santa Monica, CA 90401-1724
Mailing address
1030 E Ocean Blvd Unit 309
Long Beach, CA 90802-5534
Phone (310) 977-5779
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31258 | CA | MD | Chiropractor |
| 13668 | CA | MD | Registered Respiratory Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1244073600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1273017600000",
"number": "1912133919",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1030 E OCEAN BLVD UNIT 309",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908025534",
"telephone_number": "310-977-5779"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "710 WILSHIRE BLVD STE 314",
"city": "SANTA MONICA",
"state": "CA",
"postal_code": "904011724",
"telephone_number": "310-977-5779"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATTERS",
"first_name": "JENNIFER",
"middle_name": "M",
"credential": "D.C., L.AC.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-06-04",
"last_updated": "2010-05-05",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "31258",
"primary": true
},
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "CA",
"license": "13668",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Monica, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.