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NPI Code Detail

MEDICARE: THE LOYD WOLFE JUVENILE NETWORK

MEDICARE: THE LOYD WOLFE JUVENILE NETWORK
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM0855XAdolescent and Children Mental Health Clinic/Center

General Provider Information

NPI Number : 1053478354
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE LOYD WOLFE JUVENILE NETWORK
Provider Business Mailing Address
First Line : 2310 1ST ST
Second Line :
City : NAPA
State : CA
Zip : 94559-2239
Country : US
Telephone Number : 707-255-1855
Fax Number :
Provider Business Practice Location Address
First Line : 2310 1ST ST
Second Line :
City : NAPA
State : CA
Zip : 94559-2239
Country : US
Telephone Number : 707-255-1855
Fax Number :
Authorized Official
Title or Position : PRESIDENT OF THE BOARD
Name : DR. PATRICIA R. WOLFE
Credential :
Telephone Number : 707-255-1855
Provider Enumeration Date : 01/03/2007
Last Update Date : 08/22/2020

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Directions to “THE LOYD WOLFE JUVENILE NETWORK ” Practice Location

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