Individual
JENNESE BACON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10932 CASIMIR AVE, INGLEWOOD, CA 90303
(323) 807-6945
Mailing address
10932 CASIMIR AVE, INGLEWOOD, CA 90303-2512
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
374J00000X
Doula
—
CA
Other
Enumeration date
09/06/2018
Last updated
12/10/2025
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