Individual
MRS. PAMELA SUE WARMERDAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS RD CDE CPT
Contact information
Practice address
471 W EATON AVE, TRACY, CA 95376-3420
(209) 832-3432
(209) 839-6742
Mailing address
471 W EATON AVE, TRACY, CA 95376-3420
(209) 832-3432
(209) 839-6742
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
R703135
OH
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
09910714
CA
163WD0400X
Diabetes Educator Registered Nurse
Primary
003321
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R703135
AMERICAN DIETETIC ASSOC
—
Enumeration date
12/06/2006
Last updated
03/31/2010
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