Provider Demographics
NPI:1386001220
Name:MANLEY, JORI (DC, ATC)
Entity Type:Individual
Prefix:DR
First Name:JORI
Middle Name:
Last Name:MANLEY
Suffix:
Gender:F
Credentials:DC, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:193 JEFFERSON DR
Mailing Address - Street 2:
Mailing Address - City:MENLO PARK
Mailing Address - State:CA
Mailing Address - Zip Code:94025-1114
Mailing Address - Country:US
Mailing Address - Phone:510-521-5440
Mailing Address - Fax:650-521-5444
Practice Address - Street 1:193 JEFFERSON DR
Practice Address - Street 2:
Practice Address - City:MENLO PARK
Practice Address - State:CA
Practice Address - Zip Code:94025-1114
Practice Address - Country:US
Practice Address - Phone:510-521-5440
Practice Address - Fax:650-521-5444
Is Sole Proprietor?:No
Enumeration Date:2016-01-22
Last Update Date:2022-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2000243142255A2300X
CADC36024111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer