Provider Demographics
NPI:1124138169
Name:TARUTIS, JODI LAINE (PA-C)
Entity type:Individual
Prefix:MRS
First Name:JODI
Middle Name:LAINE
Last Name:TARUTIS
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:29573 GREENBELT CIR
Mailing Address - Street 2:
Mailing Address - City:MENIFEE
Mailing Address - State:CA
Mailing Address - Zip Code:92585-9262
Mailing Address - Country:US
Mailing Address - Phone:951-566-5454
Mailing Address - Fax:951-566-5454
Practice Address - Street 1:150 VALPREDA RD
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:CA
Practice Address - Zip Code:92069-2973
Practice Address - Country:US
Practice Address - Phone:760-736-6700
Practice Address - Fax:760-736-6700
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2021-11-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA18111363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical