Provider Demographics
NPI:1003904822
Name:SCHREUDER, WENDY M (AUD)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:M
Last Name:SCHREUDER
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:WENDY
Other - Middle Name:M
Other - Last Name:LEDERER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10470 OLD PLACERVILLE RD STE 100
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95827-2539
Mailing Address - Country:US
Mailing Address - Phone:800-470-0071
Mailing Address - Fax:
Practice Address - Street 1:2702 LOW CT
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94534-9727
Practice Address - Country:US
Practice Address - Phone:707-432-2600
Practice Address - Fax:707-432-2666
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2015-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU1096231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAZ157TMedicare PIN
ZZZ03770ZMedicare ID - Type Unspecified
CAAZ157ZMedicare PIN