Individual
KATHRYN WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTD
Contact information
Practice address
6501 CROWN BLVD STE 100A, SAN JOSE, CA 95120-2903
(408) 601-0993
Mailing address
2016 JONATHAN AVE # 2016, SAN JOSE, CA 95125-2570
(408) 618-9369
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
23218
CA
Other
Enumeration date
05/23/2022
Last updated
05/23/2022
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