Most Relevant Information
Provider Data
| NPI Number: | 1003265596 |
| Provider Name: | LENA CLAIRE VAN DER LIST D.O. |
| Entity Type: | Individual |
| Taxonomy Code: | 208000000X |
| Specialty: | Pediatrics |
| License Number: | 20A17025 |
Most Important Dates
| Enumeration Date: | 06/06/2016 |
| Last Updated: | 06/19/2020 |
Provider Practice Location
2516 STOCKTON BLVD
SACRAMENTO
CA
958172208
Practice Location Phone/Fax
| Phone: | 9167342428 |
| Fax: |
Provider Mailing Location
2516 STOCKTON BLVD
SACRAMENTO
CA
958172208
Provider Mailing Phone/Fax
| Phone: | 9167342428 |
| Fax: |
Suggested EMR
Pediatrics EMR