Wiedeman, Robert Gilbert

Wiedeman, Robert Gilbert is an individual health care provider with primary practice located at 499 Loma Alta Ave , Los Gatos CA 95030-6227. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Other Service Providers / Case Manager/Care Coordinator. Other Service Providers / Case Manager/Care Coordinator is his primary health care specialty. Wiedeman, Robert Gilbert can be contacted via phone (916) 388-6321.

Contact Information

Primary practice address
499 Loma Alta Ave Los Gatos CA 95030-6227
Phone: (916) 388-6321
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X
Other Service Providers / Case Manager/Care Coordinator 171M00000X

Profile Details

NPI number 1093844714
LBN Legal business name Wiedeman, Robert Gilbert
Credentials Master of Arts (MA)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 6th, 2007
Last updated Feb 13th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1093844714 NPPES
California MEDICAID 1093844714

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