Individual
JODI R HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPA, PA-C
Contact information
Practice address
321 CATHARINE ST, PHILADELPHIA, PA 19147-3201
(415) 310-3774
Mailing address
321 CATHARINE ST, PHILADELPHIA, PA 19147-3201
(415) 310-3774
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA16220
CA
363AM0700X
Medical Physician Assistant
Primary
MA053433
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PA16220
—
CA
Enumeration date
03/28/2007
Last updated
09/02/2016
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