Provider Demographics
NPI:1285088419
Name:STOCKTON, JON ZACHARY (DC)
Entity type:Individual
Prefix:
First Name:JON
Middle Name:ZACHARY
Last Name:STOCKTON
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 1:620 CONTRA COSTA BLVD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:PLEASANT HILL
Mailing Address - State:CA
Mailing Address - Zip Code:94523-1550
Mailing Address - Country:US
Mailing Address - Phone:925-680-8917
Mailing Address - Fax:925-680-0308
Practice Address - Street 1:620 CONTRA COSTA BLVD
Practice Address - Street 2:SUITE 203
Practice Address - City:PLEASANT HILL
Practice Address - State:CA
Practice Address - Zip Code:94523-1550
Practice Address - Country:US
Practice Address - Phone:925-680-8917
Practice Address - Fax:925-680-0308
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-13
Last Update Date:2016-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 31975111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor