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Individual

KATHRYN WICKMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2846 AMBER WOOD PL, THOUSAND OAKS, CA 91362-1236
(805) 915-9602
(805) 273-7208
Mailing address
2846 AMBER WOOD PL, THOUSAND OAKS, CA 91362-1236
(805) 915-9602
(805) 273-7208

Taxonomy

Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
570
CA

Other

Enumeration date
05/28/2019
Last updated
11/07/2022
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