Provider Demographics
NPI:1952577041
Name:STUDER, JONATHAN VERN (DC)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:VERN
Last Name:STUDER
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 1:3076 UNION AVE
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95124-2005
Mailing Address - Country:US
Mailing Address - Phone:408-559-3626
Mailing Address - Fax:
Practice Address - Street 1:3076 UNION AVE
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95124-2005
Practice Address - Country:US
Practice Address - Phone:408-559-3626
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-08
Last Update Date:2008-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18661111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor