Ciaran Jacka DPM Inc

Primary specialty

Podiatric Clinic/CenterTaxonomy code 261QP1100X

Legal business name

CIARAN JACKA DPM INC

Doing business as

Ciaran Jacka DPM Inc

Practice address

2089 Vale Rd Ste 12
San Pablo, CA 94806-3848

Phone

(510) 232-0892

Fax

(510) 234-5951

NPI assigned

Sep 6, 2022

Organization subpart

No

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

Authorized official

Name

Ciaran Jacka, DPMNPI 1891735445

Title

President

Phone

(510) 374-8213

Specialties & licenses 1

Addresses

Other names 1

• Ciaran Jacka DPM Inc Doing business as

Practitioners 1

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.

• Ciaran Jacka, DPM

  • Foot & Ankle Surgery Podiatrist
  • San Leandro, CA
  • NPI 1891735445
  NPD Authorized official

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

{
    "created_epoch": "1662422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662422400000",
    "number": "1699496927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3031 DOHR ST",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947022713",
            "telephone_number": "510-374-8213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2089 VALE RD STE 12",
            "city": "SAN PABLO",
            "state": "CA",
            "postal_code": "948063848",
            "telephone_number": "510-232-0892",
            "fax_number": "510-234-5951"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3000 Colby St Ste 107",
            "address_purpose": "LOCATION",
            "city": "Berkeley",
            "state": "CA",
            "postal_code": "947052090",
            "country_code": "US",
            "telephone_number": "510-647-3567",
            "fax_number": "510-647-3789",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CIARAN JACKA DPM INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-06",
        "last_updated": "2022-09-06",
        "certification_date": "2022-09-06",
        "status": "A",
        "authorized_official_last_name": "JACKA",
        "authorized_official_first_name": "CIARAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "510-374-8213",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ciaran Jacka DPM Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kwang Poung Chiu, M.D.
• Heeyoung Cho, PHARM.D.
• Nathalie Chow
• Stefan Christenberry
• Paul E. Cianci, M.D.
• Joscelyne Ciarroni, FNP-C
• Robert G. Clark, M.D.
• Stephanie Athena Claudatos, PHD, DBSM
• Shirley Catherine Claudio
• Kimberly Alison Coady Heikkila, LCSW

• Podiatric Clinic/Center in San Pablo, CA
• Providers in San Pablo, CA by specialty
• Podiatric Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.