Provider Demographics
NPI:1326178542
Name:JAMESON, TIMOTHY JOHN (DC)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:JOHN
Last Name:JAMESON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22179 REDWOOD RD
Mailing Address - Street 2:
Mailing Address - City:CASTRO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94546-7107
Mailing Address - Country:US
Mailing Address - Phone:510-582-5454
Mailing Address - Fax:510-582-0937
Practice Address - Street 1:22179 REDWOOD RD
Practice Address - Street 2:
Practice Address - City:CASTRO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94546-7107
Practice Address - Country:US
Practice Address - Phone:510-582-5454
Practice Address - Fax:510-582-0937
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2016-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19851111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0198510Medicare ID - Type Unspecified