MEDICARE: JUDITH IRENE TINKELENBERG RN, CNM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367A00000X	Advanced Practice Midwife	NMW538	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023106622
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUDITH IRENE TINKELENBERG RN, CNM

Provider Business Mailing Address
First Line	:	4361 RAILROAD AVE STE H
Second Line	:
City	:	PLEASANTON
State	:	CA
Zip	:	94566-6611
Country	:	US
Telephone Number	:	925-462-1755
Fax Number	:	925-462-1650

Provider Business Practice Location Address
First Line	:	5925 W LAS POSITAS BLVD STE 100
Second Line	:
City	:	PLEASANTON
State	:	CA
Zip	:	94588
Country	:	US
Telephone Number	:	925-462-1755
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/10/2006
Last Update Date	:	08/28/2019

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