Provider Demographics
NPI:1437257664
Name:COOK, JAY C (DC)
Entity Type:Individual
Prefix:
First Name:JAY
Middle Name:C
Last Name:COOK
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:SUITE 202
Mailing Address - Street 2:2600 GARDEN ROAD
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940
Mailing Address - Country:US
Mailing Address - Phone:831-375-5117
Mailing Address - Fax:831-375-3361
Practice Address - Street 1:SUITE 202
Practice Address - Street 2:2600 GARDEN ROAD
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940
Practice Address - Country:US
Practice Address - Phone:831-375-5117
Practice Address - Fax:831-375-3361
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA183666111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA18366OtherCHIROPRACTICE LIC #