Individual
KENNETH R. WULFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1503 SPRING HILL RD, PETALUMA, CA 94952-9305
(707) 559-3895
Mailing address
1503 SPRING HILL RD, PETALUMA, CA 94952-9305
(707) 559-3895
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
G32683
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G326830
—
CA
Enumeration date
10/31/2006
Last updated
01/18/2024
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