Individual
MRS. DEIRDRE BODENHAMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
10495 WHITE ROCK RD, RANCHO CORDOVA, CA 95670-5530
(916) 364-0724
Mailing address
10495 WHITE ROCK RD, RANCHO CORDOVA, CA 95670-5530
(916) 364-0724
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA 15402
CA
Other
Enumeration date
05/18/2007
Last updated
07/08/2007
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