Individual
DUSTIN K WETMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
121 SOTOYOME ST STE 201, SANTA ROSA, CA 95405
(707) 308-3101
(707) 546-4062
Mailing address
PO BOX 5510, NAPA, CA 94581-0510
(707) 252-9660
(707) 258-2780
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA22901
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA22901
PHYSICIAN ASSISTANT
CA
Enumeration date
04/11/2013
Last updated
11/11/2021
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