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General NPI Number Information
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NPI Number | 1598741969
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Entity Type | Individual
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Provider Name | MARTI FLEDDERMAN P.N.P., C.N.S., R.N.
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Gender | Female
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Dates
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Enumeration Date | 12/19/2005
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 2315 STOCKTON BLVD RM. 4302 NURSING ADMIN.
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City | SACRAMENTO
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State | CA
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Zip | 95817-2201
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Country | US
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Telephone | 916-734-8031
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Fax | 916-734-1656
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Provider Business Mailing Address
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Address Line | 3020 CARMELO LN
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City | DAVIS
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State | CA
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Zip | 95616-6555
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Country | US
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Telephone | 916-734-8031
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Fax | 916-734-1656
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | A332833
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 364SP0200X
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Taxonomy Name | Pediatric Clinical Nurse Specialist
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License Number | A332833
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License Number State | CA
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