Provider Demographics
NPI:1497462816
Name:KEDING, SHEENA R (MSN, RN, CNS, ACCNSP)
Entity Type:Individual
Prefix:
First Name:SHEENA
Middle Name:R
Last Name:KEDING
Suffix:
Gender:F
Credentials:MSN, RN, CNS, ACCNSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5609 HARVEST RD
Mailing Address - Street 2:
Mailing Address - City:ROCKLIN
Mailing Address - State:CA
Mailing Address - Zip Code:95765-5403
Mailing Address - Country:US
Mailing Address - Phone:530-228-4881
Mailing Address - Fax:
Practice Address - Street 1:1950 FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94612-5190
Practice Address - Country:US
Practice Address - Phone:510-407-2910
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-04
Last Update Date:2022-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA4354364SP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPediatrics