MARILYN A WIEDEMANN (NPI# 1164048682) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164048682 |
| Entity Type | Individual |
| Full Name | MARILYN A WIEDEMANN |
| Practice Address |
12089 Meriden Ln San Diego CA 92128-4339 |
| Practice Telephone | 8584058502 |
| Mailing Telephone | 8584058502 |
| Enumeration Date | 2020-06-20 |
| Last Update Date | 2020-06-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WA2000X |
Registered Nurse Specialization: Administrator |
244179 | CA | Nursing Service Providers |
| Street Address |
12089 MERIDEN LN |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92128-4339 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518585371 | Alicia Ford | Behavior Technician | 1170 Bernardo Plaza Court, Suite 350, San Diego, CA 92128 | 2020-07-08 |
| 1164087573 | Madeleine White | Dietitian, Registered | 16685 W Bernardo Dr, Suite 121, San Diego, CA 92128 | 2019-05-01 |
| 1053807677 | Joele Ghosn | Speech-Language Pathologist | 11838 Bernardo Plaza Ct #110, San Diego, CA 92128 | 2018-07-06 |
| 1376034348 | Eddie Reginald Burston II | In Home Supportive Care | 12727 Camino Emparrado, San Diego, CA 92128 | 2018-05-24 |
| 1336659218 | Ryan Fong | Physician Assistant | 15004 Innovation Drive (s97), San Diego, CA 92128 | 2017-10-05 |
| 1508316191 | Araceli Flores | Behavioral Analyst | 15737 Innovation Dr, Suite 200, San Diego, CA 92128 | 2016-10-07 |
| 1003283961 | Katherine Dishner | Hearing Instrument Specialist | 16766 Bernardo Center Dr Ste 206, San Diego, CA 92128 | 2015-08-27 |
| 1205212586 | Mobilia Dmd Inc. | Point of Service | 12405 Rancho Bernardo Rd., San Diego, CA 92128 | 2015-08-10 |
| 1346623634 | Angela Christine Storck-petersen | Dietitian, Registered | 11768 Caminito Corriente, San Diego, CA 92128 | 2015-07-04 |
| 1134526874 | Breeana Rose Lancaster | Speech-Language Pathologist | 11838 Bernardo Plaza Ct. Suite 110, Kids Therapy Associates, San Diego, CA 92128 | 2014-11-24 |
| Find all providers in zip 92128 | ||||
| Taxonomy Code | 163WA2000X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Administrator |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770190803 | Ma Adelver Quinitio Martin | Registered Nurse | 5912 Lomond Dr, San Diego, CA 92120-4541 | 2020-09-23 |
| 1508372095 | Redentor Patrocinio Sese | Registered Nurse | 6915 Glenflora Ave, San Diego, CA 92119-2945 | 2017-12-19 |
| 1912126350 | Shukri Yousef Adam-farah | Registered Nurse | 3896 50th St, San Diego, CA 92105 | 2007-04-24 |
| 1598846735 | Roberta L. Collins | Registered Nurse | 9400 Ruffin Ct., San Diego, CA 92123-5300 | 2006-10-17 |
| 1972168235 | Precedent Management Firm, LLC | Registered Nurse | 2305 Historic Decatur Rd, San Diego, CA 92106-6050 | 2019-05-02 |
| 1073176681 | Anne Janette Jurkowski | Registered Nurse | 3830 Valley Centre Dr Ste 702, San Diego, CA 92130-3307 | 2019-04-18 |
| 1205139086 | Jill Eileen Coughlin | Registered Nurse | 3853 Rosecrans St, San Diego, CA 92110-3115 | 2010-12-16 |
| 1962719484 | Lindsey Ryan | Registered Nurse | 3350 La Jolla Village Dr, San Diego, CA 92161-0002 | 2010-09-03 |
| 1134378128 | Patricia Sue Brubaker | Registered Nurse | 3350 La Jolla Village Dr, San Diego, CA 92161-0002 | 2008-09-15 |
| 1063630127 | Gayle Martha White | Registered Nurse | 3851 Rosecrans St, San Diego, CA 92110-3115 | 2007-04-23 |
| Find all providers in SAN DIEGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.