Healthcare Provider Details

I. General information

NPI: 1821363771
Provider Name (Legal Business Name): JOSSE FORD L.AC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/11/2012
Last Update Date: 06/03/2025
Certification Date: 06/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

533 2ND ST STE 343
ENCINITAS CA
92024-3558
US

IV. Provider business mailing address

7613 NICHOLAS WAY
CHANHASSEN MN
55317-7545
US

V. Phone/Fax

Practice location:
  • Phone: 760-944-6400
  • Fax:
Mailing address:
  • Phone: 760-944-6400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number14253
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: