Individual
JENNIFER YVONNE TREADWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, CPNP
Contact information
Practice address
1625 STOCKTON BLVD STE 112, SACRAMENTO, CA 95816-7098
(916) 887-4877
(916) 887-4835
Mailing address
1625 STOCKTON BLVD STE 112, SACRAMENTO, CA 95816-7098
(916) 887-4877
(916) 887-4835
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
95015720
CA
363LP0200X
Pediatric Nurse Practitioner
AP06244
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2336037
—
LA
01
—
292348YH54
MEDICARE - PTAN
LA
Enumeration date
04/24/2013
Last updated
01/10/2024
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