Jean A Wiedeman
Pediatric Infectious Diseases
2516 Stockton Blvd
Sacramento
, California 95817-2208
Jean A Wiedeman
Pediatric Infectious Diseases
2516 Stockton Blvd
Sacramento
, California 95817-2208
(530) 759-0726
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About
Features
Specialties
- Pediatric Infectious Diseases
Languages spoken
- English
Location
First Address
- Jean A Wiedeman
- 419 Heron Pl
- Davis, CA
- Zip : 95616-7512
- Phone : (530) 759-0726
Second Address
- Jean A Wiedeman
- 2516 Stockton Blvd
- Sacramento, CA
- Zip : 95817-2208
- Fax : (916) 734-7890
- Phone : (916) 734-3557
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2080P0208X | Pediatric Infectious Diseases | C043137 | CA |
National Provider Identifier
| NPI | 1144203423 |
|---|---|
| Provider Name | Jean A Wiedeman |
| First Address | Davis, CA 95616-7512 |
| Second Address | Sacramento, CA 95817-2208 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 21/11/2005 |
| Last Update Date | 29/11/2011 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 00C0431370 | MEDICAL# (01) | CA |
| F74255 | (02) | CA |
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.