Athena Leeann Wildenborg, T-23-2498 - Counselor in Roseville, CA

Athena Leeann Wildenborg, T-23-2498 is a Counselor based in Roseville, California. Athena Leeann Wildenborg is licensed to practice in Oregon (license number T-23-2498) and her current practice location is 200 La Loma Ct, Roseville, California. She can be reached at her office (for appointments etc.) via phone at (360) 214-4102.

NPI number for Athena Leeann Wildenborg is 1326812488 and her current mailing address is 1122 Ne 122nd Ave Ste A102, Portland, Oregon. She does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1326812488.

Contact Information

Athena Leeann Wildenborg, T-23-2498
200 La Loma Ct,
Roseville, CA 95678-2908
(360) 214-4102
Not Available

Map and Direction


Healthcare Provider's Profile

Full NameAthena Leeann Wildenborg
GenderFemale
SpecialityCounselor
Location200 La Loma Ct, Roseville, California
Accepts Medicare AssignmentsDoes not participate in Medicare Program. She may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1326812488
  • Provider Enumeration Date: 11/09/2023
  • Last Update Date: 11/09/2023

Medical Identifiers

Medical identifiers for Athena Leeann Wildenborg such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1326812488NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
101Y00000XCounselor T-23-2498 (Oregon)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Athena Leeann Wildenborg is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Athena Leeann Wildenborg, T-23-2498
1122 Ne 122nd Ave Ste A102,
Portland, OR 97230-2082

Ph: (503) 954-1890
Athena Leeann Wildenborg, T-23-2498
200 La Loma Ct,
Roseville, CA 95678-2908

Ph: (360) 214-4102

Reviews and Comments


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