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NPI Code Detail

MEDICARE: JENNY WEIDENBENNER

MEDICARE: JENNY WEIDENBENNER
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
1163WP0807XChild & Adolescent Psychiatric/Mental Health Registered Nurse848260CA
2163W00000XRegistered NurseRN848260CA

General Provider Information

NPI Number : 1164825881
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNY WEIDENBENNER
Provider Business Mailing Address
First Line : 8945 GOLF LINKS RD
Second Line :
City : OAKLAND
State : CA
Zip : 94605-4124
Country : US
Telephone Number : 510-362-5550
Fax Number :
Provider Business Practice Location Address
First Line : 8945 GOLF LINKS RD
Second Line :
City : OAKLAND
State : CA
Zip : 94605-4124
Country : US
Telephone Number : 510-362-5550
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/08/2014
Last Update Date : 03/16/2026

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Directions to “ JENNY WEIDENBENNER ” Practice Location

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