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NPI Code Detail

MEDICARE: MR. JACQUIS LAMONT TRODDER

MEDICARE: MR. JACQUIS LAMONT TRODDER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1373H00000XDay Training/Habilitation SpecialistCA

General Provider Information

NPI Number : 1538057914
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JACQUIS LAMONT TRODDER
Provider Business Mailing Address
First Line : 7309 BAYOAK WAY
Second Line :
City : CITRUS HEIGHTS
State : CA
Zip : 95621-1305
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7309 BAYOAK WAY
Second Line :
City : CITRUS HEIGHTS
State : CA
Zip : 95621-1305
Country : US
Telephone Number : 916-642-7800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/25/2025
Last Update Date : 08/23/2025

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