Individual
DR. DANA MOKRZYCKA WIDEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D
Contact information
Practice address
241 S SAN ANTONIO RD, LOS ALTOS, CA 94022-3751
(650) 328-5645
Mailing address
241 S SAN ANTONIO RD, LOS ALTOS, CA 94022-3751
(650) 328-5645
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY11581
CA
Other
Enumeration date
02/02/2024
Last updated
02/02/2024
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