Provider Demographics
NPI:1699109215
Name:THIELBAR, ANIKA
Entity type:Individual
Prefix:
First Name:ANIKA
Middle Name:
Last Name:THIELBAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANIKA
Other - Middle Name:
Other - Last Name:THIELBAR-BIRCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11344 COLOMA ROAD
Mailing Address - Street 2:#605
Mailing Address - City:GOLD RIVER
Mailing Address - State:CA
Mailing Address - Zip Code:95670-1823
Mailing Address - Country:US
Mailing Address - Phone:916-838-0926
Mailing Address - Fax:
Practice Address - Street 1:11344 COLOMA ROAD
Practice Address - Street 2:#605
Practice Address - City:GOLD RIVER
Practice Address - State:CA
Practice Address - Zip Code:95670-1823
Practice Address - Country:US
Practice Address - Phone:916-838-0926
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-30
Last Update Date:2016-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program