Provider Demographics
NPI:1114107877
Name:DAUDEL, JODY LINN (MD)
Entity Type:Individual
Prefix:DR
First Name:JODY
Middle Name:LINN
Last Name:DAUDEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 BRECK CT
Mailing Address - Street 2:
Mailing Address - City:BENICIA
Mailing Address - State:CA
Mailing Address - Zip Code:94510-1372
Mailing Address - Country:US
Mailing Address - Phone:707-205-5739
Mailing Address - Fax:
Practice Address - Street 1:210 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94589-2517
Practice Address - Country:US
Practice Address - Phone:707-645-7316
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-11
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA95421207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology