Provider Demographics
NPI:1174144786
Name:HOST, JODI SUSAN (L AC)
Entity type:Individual
Prefix:
First Name:JODI
Middle Name:SUSAN
Last Name:HOST
Suffix:
Gender:F
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 HANOVER LN STE C
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95973-7267
Mailing Address - Country:US
Mailing Address - Phone:530-592-3457
Mailing Address - Fax:
Practice Address - Street 1:28 HANOVER LN STE C
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95973-7267
Practice Address - Country:US
Practice Address - Phone:530-592-3457
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-05
Last Update Date:2020-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC18005171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist