Lisa Wiedeman, PT

Primary specialty

Pediatric Physical TherapistTaxonomy code 2251P0200X

License

32466 Issued in CA

Practice address

2425 Stockton Blvd
Sacramento, CA 95817-2215

Phone

(916) 453-2240

Fax

(916) 453-2363

NPI assigned

Sep 28, 2016

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1475020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475020800000",
    "number": "1346799616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2425 STOCKTON BLVD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172215",
            "telephone_number": "916-453-2240",
            "fax_number": "916-453-2363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2425 STOCKTON BLVD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172215",
            "telephone_number": "916-453-2240",
            "fax_number": "916-453-2363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIEDEMAN",
        "first_name": "LISA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-28",
        "last_updated": "2016-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "CA",
            "license": "32466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• Pediatric Physical Therapist in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Pediatric Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2016; 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.