Individual
WAYNE KILTHAU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5301 GERINE BLOSSOM DR, SAN JOSE, CA 95123-2118
(408) 799-1981
Mailing address
1280 PEMBRIDGE DR, SAN JOSE, CA 95118-1545
(408) 799-1981
Taxonomy
Speciality
Code
Description
License number
State
103TM1800X
Intellectual & Developmental Disabilities Psychologist
Primary
—
—
Other
Enumeration date
04/11/2016
Last updated
04/11/2016
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