Provider Demographics
NPI:1386716066
Name:JASON, DANIEL A (DC)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:A
Last Name:JASON
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 1:1819 BARCELONA ST
Mailing Address - Street 2:
Mailing Address - City:LIVERMORE
Mailing Address - State:CA
Mailing Address - Zip Code:94550-6405
Mailing Address - Country:US
Mailing Address - Phone:925-443-2062
Mailing Address - Fax:925-443-0107
Practice Address - Street 1:1819 BARCELONA ST
Practice Address - Street 2:
Practice Address - City:LIVERMORE
Practice Address - State:CA
Practice Address - Zip Code:94550-6405
Practice Address - Country:US
Practice Address - Phone:925-443-2062
Practice Address - Fax:925-443-0107
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15496111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC 0154960Medicare ID - Type Unspecified