Healthcare Provider Details

I. General information

NPI: 1962942078
Provider Name (Legal Business Name): THELMA RENEE WADSWORTH PA-C, RDH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: THELMA RENEE SCHNEIDER RDH

II. Dates (important events)

Enumeration Date: 03/08/2017
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20641 COMMERCE WAY
BURNEY CA
96013-4380
US

IV. Provider business mailing address

PO BOX 277
BIEBER CA
96009-0277
US

V. Phone/Fax

Practice location:
  • Phone: 530-335-6070
  • Fax: 530-335-4078
Mailing address:
  • Phone: 530-294-5392
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number61886
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License NumberH7246
License Number StateOR
# 3
Primary TaxonomyN
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License NumberRDH30945
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: