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John Adrian Liedecke
Student in an Organized Health Care Education/Training Program in San Rafael, California
NPI 1952829814

John Adrian Liedecke is a Student in an Organized Health Care Education/Training Program based in San Rafael, CA. John Adrian Liedecke practices in San Rafael, CA. The NPI Number for John Adrian Liedecke is 1952829814 and holds a License No. (California).

The current practice location address for John Adrian Liedecke is 20 N San Pedro Rd Ste 2021, San Rafael, CA and can be reached out via phone at 936-661-2198.

Location: 20 N San Pedro Rd Ste 2021, San Rafael, CA, 94901-4914
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1952829814
Provider Name
John Adrian Liedecke
Credential
Provider Entity Type
Individual
Gender
Male
Address
20 N San Pedro Rd Ste 2021, San Rafael, CA, 94901-4914
Phone Number
936-661-2198
Fax Number
Provider Enumeration Date
08/31/2017
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
20 N San Pedro Rd Ste 2021
City
San Rafael
State
California
Zip
94903-4158
Phone Number
936-661-2198
Fax Number
person
Provider Business Mailing Address Details
Address
20 N San Pedro Rd Ste 2021
City
San Rafael
State
California
Zip
94903-4158
Phone Number
936-661-2198
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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