Doctor Name: | KENNETH R. WULFF |
NPI Number: | 1124105085 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | G32683 |
Business Practice Address: | 770 E Calaveras Blvd Milpitas, CA - 950355491 |
Business Phone Number: | 6509452900 |
Business Fax Number: | |
Mailing Address: | 1400 Emeline Ave, SANTA CRUZ |
State: | CA |
Postal Code: | 950601976 |
Phone Number: | 8314544170 |
Fax Number: | |
NPI Enumeration Date: | 10/31/2006 |
NPI Last Update Date: | 01/12/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2084P0804X |
License Number: | G32683 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Psychiatry & Neurology |
Taxonomy Specialization: | Child & Adolescent Psychiatry |
Taxonomy Definition: | Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |