Individual
JORIS ANTON WIGGERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
165 ARCH ST, REDWOOD CITY, CA 94062-1303
(650) 862-1155
Mailing address
165 ARCH ST, REDWOOD CITY, CA 94062-1303
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
G78172
CA
Other
Enumeration date
11/30/2006
Last updated
07/09/2007
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