MEDICARE: JOANNA WIRKUS RD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian	86020068	CA

General Provider Information

NPI Number	:	1215886940
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOANNA WIRKUS RD

Provider Business Mailing Address
First Line	:	5657 8TH AVE
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95820-1723
Country	:	US
Telephone Number	:	916-439-7110
Fax Number	:

Provider Business Practice Location Address
First Line	:	2315 STOCKTON BLVD
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95817-2201
Country	:	US
Telephone Number	:	916-703-6100
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/26/2026
Last Update Date	:	01/26/2026

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