Individual
DR. JONATHAN WALDRON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
111 SMITH RANCH RD, SAN RAFAEL, CA 94903-1939
(415) 491-3000
Mailing address
111 SMITH RANCH RD, SAN RAFAEL, CA 94903-1939
(415) 491-3000
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/31/2015
Last updated
01/03/2022
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