Individual
KATHRYN WICKARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14715 EAST HIGHWAY 20, CLEARLAKE OAKS, CA 95423
(707) 668-1800
Mailing address
PO BOX 366, CLEARLAKE OAKS, CA 95423-0366
(707) 998-1800
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
271931
CA
Other
Enumeration date
05/29/2020
Last updated
05/29/2020
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