Provider Demographics
NPI:1407185515
Name:JONES, SANDI DIANE (DC)
Entity Type:Individual
Prefix:DR
First Name:SANDI
Middle Name:DIANE
Last Name:JONES
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 1:875 ESTUDILLO AVE
Mailing Address - Street 2:
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94577-5111
Mailing Address - Country:US
Mailing Address - Phone:510-667-9536
Mailing Address - Fax:267-220-5789
Practice Address - Street 1:875 ESTUDILLO AVE
Practice Address - Street 2:
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94577-5111
Practice Address - Country:US
Practice Address - Phone:510-667-9536
Practice Address - Fax:267-220-5789
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-18
Last Update Date:2009-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23026111N00000X
WA2882111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor