Type 1 · Individual ✓ Active NPI ✓ Valid NPI checksum

Dr. Kendell Desmond Jack, D.C

Chiropractor in Sebastopol, CA · enumerated 2025 · practices at Maggie Self, Lmft.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1063386829

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Registry record

Entity type Individual (Type 1)

Name Dr. Kendell Desmond Jack

Credential D.C

Sex Male

Practice address 7765 Healdsburg Ave, Sebastopol, CA, 95472

Phone (707) 823-3113

Enumeration date Oct 3, 2025

Last updated in NPPES Oct 3, 2025

Taxonomy & licenses

111N00000X Chiropractor Chiropractic Providers · License 37361 (CA) Primary

DC · Doctor of Chiropractic: A licensed chiropractor focusing on musculoskeletal and nervous system disorders. About the DC credential

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

Read the full guide → Validate an NPI →

Frequently asked questions

Is NPI 1063386829 active?

Yes, as of the latest NPPES snapshot, NPI 1063386829 is active (record last updated 2025-10-03).

How do I verify Kendell Jack's NPI record?

Cross-check NPI 1063386829 against the official CMS registry at npiregistry.cms.hhs.gov. This page mirrors the same public NPPES data with a monthly snapshot.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2025-10-03.