Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | A108028 | CA |
Y | 2080P0210X | Pediatric Nephrologist | A108028 | CA |
NPI | 1629207394 |
---|---|
Provider Name | Erica Winnicki |
First Address | Sacramento, CA 95817-2208 |
Second Address | Sacramento, CA 95817-2208 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/07/2009 |
Last Update Date | 19/09/2017 |