Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1063386829 Individual Practitioner Male Practitioner

Dr. Kendell Desmond Jack , DC

Chiropractor • Sebastopol, CA

Professional Overview & Biography Verified Profile Summary

Dr. Kendell Jack, DC is a registered healthcare professional specializing in Chiropractor in Sebastopol, CA. Practice services are available at 7765 HEALDSBURG AVE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

7765 Healdsburg Ave

Sebastopol, CA 954723309

Telephone 7078233113
Associated Practice Facility / Clinic
🏢 Maggie Self, Lmft Facility NPI 1306484605

Specialty Benchmarks & Practice Insights

Comparative analytics for Chiropractor in Sebastopol, CA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 43.0 Yrs
State Avg: 27.5 Yrs
Regional Practice Density
19 Specialists

Practicing in Sebastopol, CA (12100 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2025-10-02
Chiropractor Primary Specialty

NUCC Taxonomy Code: 111N00000X

State License CA 37361

A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

11 Associated Practitioners
Shoshana Davis , AMFT

Marriage & Family Therapist

NPI 1013484773

Associate Marriage and Family Therapist

Diana Poulson

Marriage & Family Therapist

NPI 1114241205
Maggie Self , MFT

Marriage & Family Therapist

NPI 1215199054

Marriage and Family Therapist

Elaine Gayler , MA

Marriage & Family Therapist

NPI 1225318017

Master of Arts

Chase Desso , LAC

Acupuncturist

NPI 1275915878

Licensed Acupuncturist

Angelica Jochim , MFT

Marriage & Family Therapist

NPI 1295970812

Marriage and Family Therapist

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active October 03, 2025

NPI status registered as active in NPPES database

📍
Updated Practice Location October 03, 2025

Registered at 7765 HEALDSBURG AVE, SEBASTOPOL, CA 954723309 (Tel: 7078233113)

📍
Updated Business Mailing Address October 03, 2025

Registered at 7765 HEALDSBURG AVE, SEBASTOPOL, CA 954723309 (Tel: 7078233113)

👤
Provider Name / Credentials Updated October 03, 2025

Recorded as KENDELL JACK, D.C

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) October 03, 2025

Chiropractor (License #37361 in CA)

🟢
Initial NPI Registration & Enumeration October 03, 2025

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1063386829
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 03, 2025
Last Update: October 03, 2025
Sole Proprietor: No

Mailing Address

7765 Healdsburg Ave

Sebastopol, CA 954723309

Phone: 7078233113

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.