Individual
DR. KELLY VANZUTPHEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9940 STARR RD., STE 140, WINDSOR, CA 95492
(707) 569-4545
(707) 431-2334
Mailing address
PO BOX 1497, HEALDSBURG, CA 95448
(707) 569-4545
(707) 431-2334
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PSY21716
CA
Other
Enumeration date
07/08/2009
Last updated
07/08/2009
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