Provider Demographics
NPI:1083786537
Name:NARLOCK, JILL R (DC)
Entity Type:Individual
Prefix:DR
First Name:JILL
Middle Name:R
Last Name:NARLOCK
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 1:2235 ENCINITAS BLVD STE 111
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-4356
Mailing Address - Country:US
Mailing Address - Phone:760-753-0758
Mailing Address - Fax:760-632-6895
Practice Address - Street 1:2235 ENCINITAS BLVD STE 111
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-4356
Practice Address - Country:US
Practice Address - Phone:760-753-0758
Practice Address - Fax:760-632-6895
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2022-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19227111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1083786537OtherNPI #
CADC0192270OtherBLUE SHIELD PROVIDER ID
CA19227DCMedicare ID - Type Unspecified