Provider Demographics
NPI:1346539707
Name:RINDERKNECHT, TANYA NICOLE (MD)
Entity Type:Individual
Prefix:
First Name:TANYA
Middle Name:NICOLE
Last Name:RINDERKNECHT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2335 STOCKTON BLVD. - DEPARTMENT OF SURGERY
Mailing Address - Street 2:NAOB SUITE 5023
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95817-2201
Mailing Address - Country:US
Mailing Address - Phone:650-208-9471
Mailing Address - Fax:
Practice Address - Street 1:2335 STOCKTON BLVD. - DEPARTMENT OF SURGERY
Practice Address - Street 2:NAOB SUITE 5023
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-2201
Practice Address - Country:US
Practice Address - Phone:650-208-9471
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-06
Last Update Date:2020-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1220992086S0102X, 208600000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
No208600000XAllopathic & Osteopathic PhysiciansSurgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program