Individual
CIARAN JACKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
13847 E 14TH ST STE 210, SAN LEANDRO, CA 94578-2626
(510) 351-7552
(510) 351-6009
Mailing address
13847 E 14TH ST STE 210, SAN LEANDRO, CA 94578-2626
(510) 351-7552
(510) 351-6009
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
E4622
CA
213ES0131X
Foot Surgery Podiatrist
E4622
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000E46220
—
CA
Enumeration date
06/08/2006
Last updated
04/11/2022
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