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Individual
R CHRISTIAN JESPERSON
Active
Individual
R CHRISTIAN JESPERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC14642
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0004488663
AETNA PIN #
KY
01
—
1407819386
BLUE CROSS BLUE SHIELD OF CALIFORNIA
CA
01
—
1457485080
NPI TYPE-2
CA
01
—
830345045
TAX ID
CA
01
—
830345045 0006
CIGNA PROVIDER #
CA
01
—
830345045 B
HEALTH NET
CA
01
—
830345045-003
GBS GRP BENEFITS
MD
01
—
830345045A
CALIF IRONWORKERS
CA
01
—
XXXXX7205 92021 0000
TRICARE
CA
Enumeration date
04/10/2006
Last updated
08/24/2011
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