Provider Demographics
NPI:1508631318
Name:ECKFELD, JON SCOTT (DC)
Entity Type:Individual
Prefix:DR
First Name:JON
Middle Name:SCOTT
Last Name:ECKFELD
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 1:1411 BERRYESSA RD # 40
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95133-1014
Mailing Address - Country:US
Mailing Address - Phone:669-263-6971
Mailing Address - Fax:669-263-6971
Practice Address - Street 1:1411 BERRYESSA RD # 40
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95133-1014
Practice Address - Country:US
Practice Address - Phone:669-263-6971
Practice Address - Fax:669-263-6971
Is Sole Proprietor?:No
Enumeration Date:2023-11-21
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36803111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor