Healthcare Provider Details

I. General information

NPI: 1245952076
Provider Name (Legal Business Name): JADE R WIENBAR ND
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2022
Last Update Date: 02/27/2026
Certification Date: 02/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

655 REDWOOD HWY FRONTAGE RD STE 102
MILL VALLEY CA
94941-3046
US

IV. Provider business mailing address

853 YORK ST
OAKLAND CA
94610-2166
US

V. Phone/Fax

Practice location:
  • Phone: 415-569-4470
  • Fax:
Mailing address:
  • Phone: 510-333-7590
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: