Provider Demographics
NPI:1497968887
Name:WOJCIK, JODI K (AU D)
Entity Type:Individual
Prefix:
First Name:JODI
Middle Name:K
Last Name:WOJCIK
Suffix:
Gender:F
Credentials:AU D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12630 MONTE VISTA RD
Mailing Address - Street 2:#206
Mailing Address - City:POWAY
Mailing Address - State:CA
Mailing Address - Zip Code:92064-2530
Mailing Address - Country:US
Mailing Address - Phone:858-674-1165
Mailing Address - Fax:858-674-9841
Practice Address - Street 1:12630 MONTE VISTA RD
Practice Address - Street 2:#206
Practice Address - City:POWAY
Practice Address - State:CA
Practice Address - Zip Code:92064-2530
Practice Address - Country:US
Practice Address - Phone:858-674-1165
Practice Address - Fax:858-674-9841
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2010-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU586231H00000X, 237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter