Provider Demographics
NPI:1104816495
Name:JOBE, VICKI LYNN (DC)
Entity type:Individual
Prefix:DR
First Name:VICKI
Middle Name:LYNN
Last Name:JOBE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:5655 COLBOURN PL
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94619-3508
Mailing Address - Country:US
Mailing Address - Phone:510-268-8775
Mailing Address - Fax:510-531-5890
Practice Address - Street 1:5655 COLBOURN PL
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94619-3508
Practice Address - Country:US
Practice Address - Phone:510-268-8775
Practice Address - Fax:510-531-5890
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-27
Last Update Date:2013-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19855111N00000X
CA00002332227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered