Jean A Wiedeman, M.D.

Primary specialty

Pediatric Infectious Diseases PhysicianTaxonomy code 2080P0208X

License

C043137 Issued in CA

Practice address

2516 Stockton Blvd
Sacramento, CA 95817-2208

Phone

(916) 734-3557

Fax

(916) 734-7890

NPI assigned

Nov 21, 2005

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Regents of the Univ of Ca

  • Pulmonary Disease Physician
  • Sacramento, CA
  • NPI 1437142692
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1132531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322524800000",
    "number": "1144203423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "419 HERON PL",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "956167512",
            "telephone_number": "530-759-0726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2516 STOCKTON BLVD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172208",
            "telephone_number": "916-734-3557",
            "fax_number": "916-734-7890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIEDEMAN",
        "first_name": "JEAN",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-21",
        "last_updated": "2011-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0208X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Infectious Diseases",
            "state": "CA",
            "license": "C043137",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL#",
            "identifier": "00C0431370",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tatyana Widener
• Kioko Widjaja
• Minna Minsing Chen Wieck, MD
• Sabina Wieczner
• Geoffrey Paul Wiedeman Jr., M.D.
• Lisa Wiedeman, PT
• Julius Mombo Wiefue
• Nasim Wiegley, M.D.
• Ellen A Wiegner, MD
• Alexandra Wiese

• Pediatric Infectious Diseases Physician in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Pediatric Infectious Diseases Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.