Jessica Lyn Bodary
Podiatrist Prosthetist
895 Third Ave Bldg 2
Chula Vista
, California 91911-1304
Jessica Lyn Bodary
Podiatrist Prosthetist
895 Third Ave Bldg 2
Chula Vista
, California 91911-1304
(517) 528-7549
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About
Features
Specialties
- Podiatrist
- Prosthetist
Languages spoken
- English
Location
First Address
- Jessica Lyn Bodary
- 4117 Idaho St
- San Diego, CA
- Zip : 92104-1805
- Phone : (517) 528-7549
Second Address
- Jessica Lyn Bodary
- 895 Third Ave Bldg 2
- Chula Vista, CA
- Zip : 91911-1304
- Phone : (619) 585-8421
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | CPO04202 | CA |
| Y | 222Z00000X | Podiatrist | CPO04202 | CA |
| N | 224P00000X | Prosthetist | CPO04202 | CA |
National Provider Identifier
| NPI | 1083278212 |
|---|---|
| Provider Name | Jessica Lyn Bodary |
| First Address | San Diego, CA 92104-1805 |
| Second Address | Chula Vista, CA 91911-1304 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 23/04/2019 |
| Last Update Date | 23/04/2019 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.