Provider Demographics
NPI:1659644375
Name:REICHERT, JEFFREY (DC, BS)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:
Last Name:REICHERT
Suffix:
Gender:M
Credentials:DC, BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21669 REDWOOD RD
Mailing Address - Street 2:
Mailing Address - City:CASTRO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94546-6431
Mailing Address - Country:US
Mailing Address - Phone:510-582-7418
Mailing Address - Fax:510-582-7244
Practice Address - Street 1:21669 REDWOOD RD
Practice Address - Street 2:
Practice Address - City:CASTRO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94546-6431
Practice Address - Country:US
Practice Address - Phone:510-582-7418
Practice Address - Fax:510-582-7244
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-10
Last Update Date:2017-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32181111N00000X, 111NP0017X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NP0017XChiropractic ProvidersChiropractorPediatric Chiropractor