Provider Demographics
NPI:1639122930
Name:JOINER, WENDI S (MD)
Entity type:Individual
Prefix:
First Name:WENDI
Middle Name:S
Last Name:JOINER
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 1:3 6TH STREET
Mailing Address - Street 2:
Mailing Address - City:POINT REYES STATION
Mailing Address - State:CA
Mailing Address - Zip Code:94956
Mailing Address - Country:US
Mailing Address - Phone:415-663-8666
Mailing Address - Fax:415-663-9532
Practice Address - Street 1:88 MESA RD
Practice Address - Street 2:
Practice Address - City:BOLINAS
Practice Address - State:CA
Practice Address - Zip Code:94924-9713
Practice Address - Country:US
Practice Address - Phone:415-868-0124
Practice Address - Fax:415-868-2152
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-18
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA88954207Q00000X
OK23011207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A889540Medicaid
BJ8416794OtherDEA
CA00A889540Medicaid