Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Ava Marie Wiedemann, PA-C

Individual provider Physician Assistant · NPI 1104469055

Ava Marie Wiedemann, PA-C is a Physician Assistant in San Diego, California. Works from 2 locations. Licensed in California.

Licensed in
CA
In the registry since
2019
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

9665 Chesapeake Dr Ste 350
San Diego, CA 92123-1352
Phone: (877) 260-2261
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2101 Rosecrans Ave # 3230, El Segundo, CA 90245-4749 — (323) 628-8671

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA57411 (CA)

Record details

NPI number1104469055
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedOctober 23, 2019
Last updated in NPPESNovember 8, 2019

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