Provider Demographics
NPI:1649289943
Name:HEWITT, RHONDA L (NP)
Entity type:Individual
Prefix:MS
First Name:RHONDA
Middle Name:L
Last Name:HEWITT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 PASTEUR DR
Mailing Address - Street 2:MC:5500
Mailing Address - City:STANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:94305-2200
Mailing Address - Country:US
Mailing Address - Phone:650-723-9729
Mailing Address - Fax:650-498-4249
Practice Address - Street 1:300 PASTEUR DR
Practice Address - Street 2:MC:5500
Practice Address - City:STANFORD
Practice Address - State:CA
Practice Address - Zip Code:94305-2200
Practice Address - Country:US
Practice Address - Phone:650-723-9729
Practice Address - Fax:650-498-4249
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2007-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10274363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00102740Medicaid
CA00102740Medicaid
CAS79114Medicare UPIN