Healthcare Provider Details

I. General information

NPI: 1497462816
Provider Name (Legal Business Name): SHEENA R KEDING MSN, RN, CNS, ACCNSP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/04/2022
Last Update Date: 11/04/2022
Certification Date: 09/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1950 FRANKLIN ST
OAKLAND CA
94612-5190
US

IV. Provider business mailing address

5609 HARVEST RD
ROCKLIN CA
95765-5403
US

V. Phone/Fax

Practice location:
  • Phone: 510-407-2910
  • Fax:
Mailing address:
  • Phone: 530-228-4881
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0200X
TaxonomyPediatric Clinical Nurse Specialist
License Number4354
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: