Healthcare Provider Details

I. General information

NPI: 1679625818
Provider Name (Legal Business Name): KIMBERLY LYNN STERNER CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2007
Last Update Date: 06/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1321 COTTONWOOD ST FL 3
WOODLAND CA
95695
US

IV. Provider business mailing address

3400 DATA DR 1ST
RANCHO CORDOVA CA
95670-7956
US

V. Phone/Fax

Practice location:
  • Phone: 530-668-2600
  • Fax: 530-661-2410
Mailing address:
  • Phone: 916-379-2726
  • Fax: 916-853-7874

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number1622
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number586180
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: