Ava Wiedemann, PA-C
NPI 1104469055 · Physician Assistant · San Diego, CA
Enrolled with Medicare as Practitioner - Physician Assistant · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Ava Wiedemann, PA-C is a Physician Assistant provider in San Diego, CA (NPI 1104469055).
Provider details
- NPI number
- 1104469055
- Entity type
- Individual
- Primary specialty
- Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- License
- PA57411 (CA)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
6 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Additional practice locations (1)
- 2101 Rosecrans Ave # 3230El Segundo, CA 90245-4749Phone: (323) 628-8671
Registry dates
- Enumerated
- 2019-10-23
- Last updated
- 2019-11-08
Frequently asked questions
- What is Ava Wiedemann's NPI number?
- Ava Wiedemann's National Provider Identifier (NPI) is 1104469055, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Ava Wiedemann's specialty?
- Ava Wiedemann is listed in the NPPES registry with a primary specialty of Physician Assistant (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Ava Wiedemann located?
- Ava Wiedemann's practice location on file with NPPES is 9665 Chesapeake Dr Ste 350, San Diego, CA 92123-1352.
- What is Ava Wiedemann's phone number?
- The practice phone number listed in the NPPES registry for Ava Wiedemann is (877) 260-2261.
- Does Ava Wiedemann accept Medicare?
- Ava Wiedemann is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Ava Wiedemann's NPI active?
- Yes — Ava Wiedemann's NPI (1104469055) is active in the NPPES registry as of the last update on 2019-11-08.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.