Individual
STEPHANIE LISETTE BEDOLLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
1179 N MCDOWELL BLVD, PETALUMA, CA 94954-6559
(707) 559-7500
Mailing address
1179 N MCDOWELL BLVD, PETALUMA, CA 94954-6559
(707) 559-7500
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
95002835
CA
363LA2200X
Adult Health Nurse Practitioner
NPP37728
RI
363LA2200X
Adult Health Nurse Practitioner
RN2275566
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11009205/A
—
MA
05
—
SB90061
—
RI
Enumeration date
10/18/2011
Last updated
06/17/2025
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