Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jerry Wallace Fulford

Individual provider Massage Therapist · NPI 1427547355

Jerry Wallace Fulford is a Massage Therapist in Capitola, California. Licensed in California. Registered with an NPI since 2018.

Licensed in
CA
In the registry since
2018

Practice location Address checks out

4170 Gross Rd Ext Ste 6
Capitola, CA 95010
Phone: (831) 464-1605
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Massage Therapist (primary) Taxonomy 225700000X · Licence 75622 (CA)

Record details

NPI number1427547355
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMay 7, 2018
Last updated in NPPESMay 7, 2018
Mailing address4170 Gross Rd. Extension, Suite 6, Capitola, CA 95010

Other providers in Capitola