Healthcare Provider Details

I. General information

NPI: 1790552305
Provider Name (Legal Business Name): JODI MICHELE CHOPLIN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/05/2023
Last Update Date: 01/02/2025
Certification Date: 01/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 LA CASA VIA STE 208
WALNUT CREEK CA
94598-3007
US

IV. Provider business mailing address

1000 POWELL ST APT 53
SAN FRANCISCO CA
94108-1562
US

V. Phone/Fax

Practice location:
  • Phone: 925-935-1070
  • Fax:
Mailing address:
  • Phone: 415-589-1945
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95028017
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: