Healthcare Provider Details

I. General information

NPI: 1457260200
Provider Name (Legal Business Name): KARI JO ZIEGENHAGEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/04/2026
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1905 E BEAMER ST
WOODLAND CA
95776-6257
US

IV. Provider business mailing address

591 MATMOR RD APT 3
WOODLAND CA
95776-5782
US

V. Phone/Fax

Practice location:
  • Phone: 530-662-2699
  • Fax:
Mailing address:
  • Phone: 530-405-6815
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License NumberMPSS-JRXVKS
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: