Individual
MS. JILL MAUREEN DIETIKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHN
Contact information
Practice address
20111 CEDAR RD N, SONORA, CA 95370-5939
(209) 533-7415
Mailing address
20111 CEDAR RD N, SONORA, CA 95370-5939
(209) 533-7415
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
RN358410
CA
Other
Enumeration date
12/12/2011
Last updated
12/12/2011
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