Provider Demographics
NPI:1649551706
Name:WINEMILLER, JODI JEAN (CNM, MSN, RN)
Entity type:Individual
Prefix:MS
First Name:JODI
Middle Name:JEAN
Last Name:WINEMILLER
Suffix:
Gender:F
Credentials:CNM, MSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1304 MARIN AVE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:CA
Mailing Address - Zip Code:94706-2102
Mailing Address - Country:US
Mailing Address - Phone:619-251-9202
Mailing Address - Fax:
Practice Address - Street 1:1580 VALENCIA ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-4423
Practice Address - Country:US
Practice Address - Phone:415-641-6996
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-02
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
176B00000X
CA2044367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA840573OtherREGISTERED NURSE
CA2044OtherNURSE MIDWIFE FURNISHING LICENSE
CA2044OtherNURSE MIDWIFE