Individual
LAUREN VAN WIETMARSCHEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, CNM, NP
Contact information
Practice address
22331 MISSION BLVD, HAYWARD, CA 94541-3911
(510) 471-5880
Mailing address
22331 MISSION BLVD, HAYWARD, CA 94541-3911
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
824483
CA
363LW0102X
Women's Health Nurse Practitioner
95001606
CA
367A00000X
Advanced Practice Midwife
Primary
235697
CA
Other
Enumeration date
10/28/2014
Last updated
03/09/2015
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