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General NPI Number Information
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NPI Number | 1144640368
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Entity Type | Individual
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Provider Name | JODI TODD R.D.H.A.P.
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Gender | Female
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Dates
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Enumeration Date | 04/27/2014
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Last Update Date | 01/19/2021
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Provider Practice Location Address
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Address Line | 244 HOSPITAL DR STE B
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City | UKIAH
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State | CA
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Zip | 95482-4557
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Country | US
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Telephone | 707-272-4426
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Fax |
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Provider Business Mailing Address
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Address Line | 561 SARATOGA CT
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City | UKIAH
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State | CA
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Zip | 95482-4187
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Country | US
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Telephone | 707-272-4426
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | RDH 22675
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | HAP 517
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License Number State | CA
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