Healthcare Provider Details

I. General information

NPI: 1699932566
Provider Name (Legal Business Name): VICTORIA ANN WOLFE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2008
Last Update Date: 05/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3801 MIRANDA AVE
PALO ALTO CA
94304-1207
US

IV. Provider business mailing address

707 CONTINENTAL CIR APT 1125
MOUNTAIN VIEW CA
94040-3311
US

V. Phone/Fax

Practice location:
  • Phone: 650-493-5000
  • Fax: 650-852-3455
Mailing address:
  • Phone: 650-450-2063
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WU0100X
TaxonomyUrology Registered Nurse
License Number6664
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: