Provider Demographics
NPI:1891795332
Name:VANDEN BRANDEN, JUDITH M (RNP)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:M
Last Name:VANDEN BRANDEN
Suffix:
Gender:F
Credentials:RNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6889 VIA QUITO
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94566-5759
Mailing Address - Country:US
Mailing Address - Phone:925-846-9125
Mailing Address - Fax:510-483-1099
Practice Address - Street 1:6889 VIA QUITO
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94566-5759
Practice Address - Country:US
Practice Address - Phone:925-846-9125
Practice Address - Fax:510-483-1099
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA148583363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology