Provider Demographics
NPI:1821363771
Name:FORD, JOSSE (LAC)
Entity type:Individual
Prefix:
First Name:JOSSE
Middle Name:
Last Name:FORD
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:7613 NICHOLAS WAY
Mailing Address - Street 2:
Mailing Address - City:CHANHASSEN
Mailing Address - State:MN
Mailing Address - Zip Code:55317-7545
Mailing Address - Country:US
Mailing Address - Phone:760-944-6400
Mailing Address - Fax:
Practice Address - Street 1:533 2ND ST STE 343
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-3558
Practice Address - Country:US
Practice Address - Phone:760-944-6400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-11
Last Update Date:2025-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14253171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist