Active NPI
Jaehyea Wiedeman
- Pharmacist
- Anderson, CA
National Provider Identifier
1730779372
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 70524
- Practice address
- 2940 East St
Anderson, CA 96007-3411 - Phone
- (530) 378-5566
- NPI assigned
- Jan 18, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 70524 | CA | Primary |
Addresses
Primary practice location
2940 East St
Anderson, CA 96007-3411
Mailing address
935 5TH Ave
Orland, CA 95963-9533
Phone (530) 966-6480
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 70524 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1610928000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1610928000000",
"number": "1730779372",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "935 5TH AVE",
"city": "ORLAND",
"state": "CA",
"postal_code": "959639533",
"telephone_number": "530-966-6480"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2940 EAST ST",
"city": "ANDERSON",
"state": "CA",
"postal_code": "960073411",
"telephone_number": "530-378-5566"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIEDEMAN",
"first_name": "JAEHYEA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-01-18",
"last_updated": "2021-01-18",
"certification_date": "2021-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "70524",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Anderson, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.