Pamela Sue Warmerdam, MS RD CDE CPT

Primary specialty

Diabetes Educator Registered NurseTaxonomy code 163WD0400X

License

003321 Issued in CA

Practice address

471 W Eaton Ave
Tracy, CA 95376-3420

Phone

(209) 832-3432

Fax

(209) 839-6742

NPI assigned

Dec 6, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269993600000",
    "number": "1710046966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "471 W EATON AVE",
            "city": "TRACY",
            "state": "CA",
            "postal_code": "953763420",
            "telephone_number": "209-832-3432",
            "fax_number": "209-839-6742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "471 W EATON AVE",
            "city": "TRACY",
            "state": "CA",
            "postal_code": "953763420",
            "telephone_number": "209-832-3432",
            "fax_number": "209-839-6742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARMERDAM",
        "first_name": "PAMELA",
        "middle_name": "SUE",
        "name_prefix": "Mrs.",
        "credential": "MS RD CDE CPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-06",
        "last_updated": "2010-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OH",
            "license": "R703135",
            "primary": false
        },
        {
            "code": "163WA0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "09910714",
            "primary": false
        },
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "CA",
            "license": "003321",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN DIETETIC ASSOC",
            "identifier": "R703135",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Puneet Waraich
• Angela Michelle Ward
• Jazmyn Olivia Ward
• Kelly Elizabeth Ward, MS
• Caleb Wardle
• Alicia M Warn, AMFT, APCC
• Sylvia Supreme Warner
• Warta Enterprise, Inc.
• Annette Warwick, PA-C
• Keith E Warwick

• Diabetes Educator Registered Nurse in Tracy, CA
• Providers in Tracy, CA by specialty
• Diabetes Educator Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2010; 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.