Provider Demographics
NPI:1447071998
Name:WALDER, AMIE (LM)
Entity type:Individual
Prefix:
First Name:AMIE
Middle Name:
Last Name:WALDER
Suffix:
Gender:F
Credentials:LM
Other - Prefix:
Other - First Name:AMIE
Other - Middle Name:
Other - Last Name:SHERMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8743 ALGONQUIN WAY
Mailing Address - Street 2:
Mailing Address - City:ORANGEVALE
Mailing Address - State:CA
Mailing Address - Zip Code:95662-2342
Mailing Address - Country:US
Mailing Address - Phone:916-698-8184
Mailing Address - Fax:
Practice Address - Street 1:8743 ALGONQUIN WAY
Practice Address - Street 2:
Practice Address - City:ORANGEVALE
Practice Address - State:CA
Practice Address - Zip Code:95662-2342
Practice Address - Country:US
Practice Address - Phone:916-698-8184
Practice Address - Fax:916-527-2272
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-17
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALM748176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife