Healthcare Provider Details

I. General information

NPI: 1083900807
Provider Name (Legal Business Name): WENDY VROMAN CATC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/20/2011
Last Update Date: 06/20/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3789 HOOVER ST
REDWOOD CITY CA
94063-4504
US

IV. Provider business mailing address

450 REDWOOD AVE APT. 17
REDWOOD CITY CA
94061-3079
US

V. Phone/Fax

Practice location:
  • Phone: 650-363-8735
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCATC# 051205
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: