Provider Demographics
NPI:1962014407
Name:THOMPSON, JOSEPHLUCAS (DC)
Entity Type:Individual
Prefix:DR
First Name:JOSEPHLUCAS
Middle Name:
Last Name:THOMPSON
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 1:2209 9TH ST
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94710-2321
Mailing Address - Country:US
Mailing Address - Phone:585-329-2415
Mailing Address - Fax:
Practice Address - Street 1:236 OAK MEADOW DR
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-4452
Practice Address - Country:US
Practice Address - Phone:408-356-9125
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-17
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34837111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor