Provider Demographics
NPI:1124165220
Name:WEINSHIENK, KAY (DO)
Entity type:Individual
Prefix:DR
First Name:KAY
Middle Name:
Last Name:WEINSHIENK
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2460
Mailing Address - Street 2:
Mailing Address - City:NEVADA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95959-1948
Mailing Address - Country:US
Mailing Address - Phone:530-575-9897
Mailing Address - Fax:
Practice Address - Street 1:145 PLEASANT HILL AVE N STE 104
Practice Address - Street 2:
Practice Address - City:SEBASTOPOL
Practice Address - State:CA
Practice Address - Zip Code:95472-3110
Practice Address - Country:US
Practice Address - Phone:707-824-9090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A7334208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA020A73340Medicare ID - Type Unspecified