Provider Demographics
NPI:1619024908
Name:VYHMEISTER, JUDITH C (MD)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:C
Last Name:VYHMEISTER
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 1:101 HOSPITAL RD
Mailing Address - Street 2:TUOLUMNE GENERAL HOSPITAL PSYCH DEPARTMENT
Mailing Address - City:SONORA
Mailing Address - State:CA
Mailing Address - Zip Code:95370-5227
Mailing Address - Country:US
Mailing Address - Phone:209-533-7198
Mailing Address - Fax:
Practice Address - Street 1:101 HOSPITAL RD
Practice Address - Street 2:TUOLUMNE GENERAL HOSPITAL PSYCH DEPARTMENT
Practice Address - City:SONORA
Practice Address - State:CA
Practice Address - Zip Code:95370-5227
Practice Address - Country:US
Practice Address - Phone:209-533-7198
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA485162084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
A48516Medicare UPIN