Healthcare Provider Details

I. General information

NPI: 1649551706
Provider Name (Legal Business Name): JODI JEAN WINEMILLER CNM, MSN, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2011
Last Update Date: 10/21/2024
Certification Date: 10/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1580 VALENCIA ST
SAN FRANCISCO CA
94110-4423
US

IV. Provider business mailing address

1304 MARIN AVE
ALBANY CA
94706-2102
US

V. Phone/Fax

Practice location:
  • Phone: 415-641-6996
  • Fax:
Mailing address:
  • Phone: 619-251-9202
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number2044
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: