Provider Demographics
NPI:1629204599
Name:WADELL, PAULA (MD)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:
Last Name:WADELL
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 1:3416 AMERICAN RIVER DR STE B
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95864-5753
Mailing Address - Country:US
Mailing Address - Phone:916-232-6197
Mailing Address - Fax:916-404-0205
Practice Address - Street 1:3416 AMERICAN RIVER DR STE B
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95864-5753
Practice Address - Country:US
Practice Address - Phone:916-232-6197
Practice Address - Fax:916-404-0205
Is Sole Proprietor?:No
Enumeration Date:2009-06-05
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1137332084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry