Healthcare Provider Details

I. General information

NPI: 1902850399
Provider Name (Legal Business Name): JACQUELINE ANDREE MEAD-GOYETTE D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2006
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1350 W ROBINHOOD DR STE 12
STOCKTON CA
95207-5514
US

IV. Provider business mailing address

1350 W ROBINHOOD DR STE 12
STOCKTON CA
95207-5514
US

V. Phone/Fax

Practice location:
  • Phone: 209-603-0627
  • Fax:
Mailing address:
  • Phone: 209-603-0627
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC0246870
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: