Individual provider Active NPI

Jon Mark Kakleas, D.C., P.T.

  • Chiropractor
  • San Rafael, CA
National Provider Identifier
1184841728
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC 23537 Issued in CA
Practice address
4380 Redwood Hwy Ste B6
San Rafael, CA 94903-2110
Phone
(415) 499-8469
Fax
(415) 499-8645
NPI assigned
Apr 18, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC 23537 CA Primary
Physical Therapist 225100000X PT 109380 CA

Addresses

Primary practice location

4380 Redwood Hwy Ste B6
San Rafael, CA 94903-2110

Mailing address

4380 Redwood Highway, Ste. B-6
San Rafael, CA 94903
Phone (415) 499-8469

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040826001328 CA Practitioner - Physical Therapist in Private Practice 3971578683 Reassigns benefits to 1 organization
I20131205000308 CA Practitioner - Chiropractic 3971578683 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1981
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4380 Redwood Hwy
San Rafael, CA 94903-2110
Phone (415) 499-8469

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
23537CAMDClinical Psychologist
DC 23537CAMDChiropractor
PT 109380CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kakleas Chiropractic, Inc. Physical Therapist CurrentSince Aug 26, 2004 Accepting new patients
Zollner Precision Chiropractic and Wellness Inc. Chiropractor PastSince Aug 16, 2004 Accepting new patients

Locations

4380 Redwood Hwy
San Rafael, CA 94903
Phone (415) 499-8469

4380 Redwood Hwy
Ste B6
San Rafael, CA 94903
Phone (415) 499-8469

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1184841728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4380 REDWOOD HIGHWAY, STE. B-6",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "94903",
            "telephone_number": "415-499-8469",
            "fax_number": "415-499-8645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4380 REDWOOD HWY STE B6",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949032110",
            "telephone_number": "415-499-8469",
            "fax_number": "415-499-8645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAKLEAS",
        "first_name": "JON",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "D.C., P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-18",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC 23537",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT 109380",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Rafael, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.