Provider Demographics
NPI:1336716620
Name:JODI TODD RDHAP, INC.
Entity Type:Organization
Organization Name:JODI TODD RDHAP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JODI
Authorized Official - Middle Name:
Authorized Official - Last Name:TODD
Authorized Official - Suffix:
Authorized Official - Credentials:RDHAP
Authorized Official - Phone:707-272-4426
Mailing Address - Street 1:561 SARATOGA CT
Mailing Address - Street 2:
Mailing Address - City:UKIAH
Mailing Address - State:CA
Mailing Address - Zip Code:95482-4187
Mailing Address - Country:US
Mailing Address - Phone:707-272-4426
Mailing Address - Fax:
Practice Address - Street 1:244 HOSPITAL DR STE B
Practice Address - Street 2:
Practice Address - City:UKIAH
Practice Address - State:CA
Practice Address - Zip Code:95482-4557
Practice Address - Country:US
Practice Address - Phone:707-467-9733
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-07
Last Update Date:2021-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental