Provider Demographics
NPI:1578820080
Name:WENBERG, ALICIA SUZANNE (MD)
Entity Type:Individual
Prefix:DR
First Name:ALICIA
Middle Name:SUZANNE
Last Name:WENBERG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1665 ESPLANADE
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-3312
Mailing Address - Country:US
Mailing Address - Phone:530-895-0423
Mailing Address - Fax:530-895-1872
Practice Address - Street 1:1665 ESPLANADE
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-3312
Practice Address - Country:US
Practice Address - Phone:530-895-0423
Practice Address - Fax:530-895-1872
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-20
Last Update Date:2014-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA120526207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology