Provider Demographics
NPI:1366519407
Name:WOLZ, BIRGIT MAGDALENA (PHD)
Entity type:Individual
Prefix:
First Name:BIRGIT
Middle Name:MAGDALENA
Last Name:WOLZ
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3886 DEER MEADOW LN # 2
Mailing Address - Street 2:
Mailing Address - City:OCCIDENTAL
Mailing Address - State:CA
Mailing Address - Zip Code:95465-9287
Mailing Address - Country:US
Mailing Address - Phone:707-533-7981
Mailing Address - Fax:707-922-0333
Practice Address - Street 1:3886 DEER MEADOW LN # 2
Practice Address - Street 2:
Practice Address - City:OCCIDENTAL
Practice Address - State:CA
Practice Address - Zip Code:95465-9287
Practice Address - Country:US
Practice Address - Phone:707-533-7981
Practice Address - Fax:707-922-0333
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC32637106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist