Provider Demographics
NPI:1033353230
Name:LUEDEKE, KATHLEEN JEANETTE
Entity Type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:JEANETTE
Last Name:LUEDEKE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2853 GROOM DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:CA
Mailing Address - Zip Code:94806-2664
Mailing Address - Country:US
Mailing Address - Phone:510-223-4236
Mailing Address - Fax:
Practice Address - Street 1:2853 GROOM DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:CA
Practice Address - Zip Code:94806-2664
Practice Address - Country:US
Practice Address - Phone:510-223-4236
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-01
Last Update Date:2009-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator