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JERRY WALLACE FULFORD
NPI 1427547355
Massage Therapist in Capitola, CA

Active since May 07, 2018
4170 GROSS RD. EXTENSION, SUITE 6, CAPITOLA, CA 95010(831) 464-1605 Get Directions Write a Review

NPPES record last updated: May 7, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jerry Wallace Fulford NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JERRY WALLACE FULFORD (NPI 1427547355) is an individual massage therapist in Capitola, California, licensed in California (75622) and active in the NPI registry since May 2018.

NPPES Registry Identity

NPI1427547355
Entity TypeIndividualMale
Primary Taxonomy225700000X
Provider Legal NameJERRY WALLACE FULFORD
Location Address4170 GROSS RD. EXTENSION, SUITE 6Capitola, CA 95010
Mailing Address4170 Gross Rd. Extension, Suite 6Capitola, CA 95010
Phone(831) 464-1605
Sole ProprietorNo
Enumeration DateMay 7, 2018
✔ NPI 1427547355 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225700000X
License✔ Licensed in CA · 75622
Definition
An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.
4170 GROSS RD. EXTENSION, Capitola, CA 95010
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jerry Fulford's NPI number?

The NPI number for Jerry Fulford is 1427547355. It was assigned to this individual provider in the NPPES registry on May 7, 2018.

Where is Jerry Fulford located?

Jerry Fulford practices at 4170 Gross Rd. Extension Suite 6, Capitola, CA 95010. The listed phone number is (831) 464-1605.

What is Jerry Fulford's specialty?

The primary specialty registered for this NPI is Massage Therapist with taxonomy code 225700000X.

When was this NPI record last updated?

The NPPES record for Jerry Fulford was last updated on May 7, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.