Organization Active NPI

Kakleas Chiropractic, Inc.

  • Physical Therapist
  • San Rafael, CA
National Provider Identifier
1528227832
Registry record updated Jun 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
0PT109380 Issued in CA
Legal business name
KAKLEAS CHIROPRACTIC, INC.
Practice address
4380 Redwood Hwy
Suite B6
San Rafael, CA 94903-2120
Phone
(415) 499-8469
Fax
(415) 499-8645
NPI assigned
Jun 3, 2008
Last updated
Jun 5, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2026

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

Authorized official

Name
Jon Mark KakleasNPI 1184841728
Title
Owner
Phone
(415) 499-8469

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 0PT109380 CA Primary

Addresses

Primary practice location

4380 Redwood Hwy
Suite B6
San Rafael, CA 94903-2120

Mailing address

4380 Redwood Hwy Ste B6
San Rafael, CA 94903-2110
Phone (415) 499-8469

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040826001278 CA Part B Supplier - Clinic/Group Practice 0446225155 Receives reassigned benefits from 2 practitioners
Practice locations: San Rafael, CA

National Provider Directory

National Provider Directory

Locations

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

2045 Royal Ave
Ste 210
Simi Valley, CA 93065

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1212451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780617600000",
    "number": "1528227832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4380 REDWOOD HWY",
            "address_2": "SUITE B6",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949032120",
            "telephone_number": "415-499-8469",
            "fax_number": "415-499-8645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAKLEAS CHIROPRACTIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-03",
        "last_updated": "2026-06-05",
        "certification_date": "2026-06-05",
        "status": "A",
        "authorized_official_last_name": "KAKLEAS",
        "authorized_official_first_name": "JON",
        "authorized_official_middle_name": "MARK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "415-499-8469"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "0PT109380",
            "primary": true
        }
    ],
    "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 Jun 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.