Active NPI
Jon Jerrod Serafin, D.C.
- Chiropractor
- Lathrop, CA
National Provider Identifier
1972680247
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- DC24993
- Practice address
- 16972 S Harlan Rd
Lathrop, CA 95330-8738 - Phone
- (209) 858-1029
- Fax
- (209) 858-1039
- NPI assigned
- Nov 1, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | DC24993 | CA | Primary |
Addresses
Primary practice location
16972 S Harlan Rd
Lathrop, CA 95330-8738
Mailing address
1124 Vintner Way
Pleasanton, CA 94566-6935
Phone (925) 525-5665
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100626000457 | CA | Practitioner - Chiropractic | 3274664735 | Practice locations: Lathrop, CA |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1972680247",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1124 VINTNER WAY",
"city": "PLEASANTON",
"state": "CA",
"postal_code": "945666935",
"telephone_number": "925-525-5665",
"fax_number": "209-858-1039"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16972 S HARLAN RD",
"city": "LATHROP",
"state": "CA",
"postal_code": "953308738",
"telephone_number": "209-858-1029",
"fax_number": "209-858-1039"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SERAFIN",
"first_name": "JON",
"middle_name": "JERROD",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "DC24993",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lathrop, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.