Provider Demographics
NPI:1023274396
Name:WADEMAN, JENNIFER ELIZABETH (OD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:ELIZABETH
Last Name:WADEMAN
Suffix:
Gender:F
Credentials:OD
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Mailing Address - Street 1:2545 E BIDWELL ST
Mailing Address - Street 2:STE 160
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-6442
Mailing Address - Country:US
Mailing Address - Phone:916-539-5030
Mailing Address - Fax:530-885-1221
Practice Address - Street 1:2545 E BIDWELL ST
Practice Address - Street 2:SUITE 160
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-6440
Practice Address - Country:US
Practice Address - Phone:916-983-0896
Practice Address - Fax:916-983-0172
Is Sole Proprietor?:No
Enumeration Date:2008-08-05
Last Update Date:2016-12-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA13507152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist