Provider Demographics
NPI:1992907398
Name:WILKIN, JUDITH ANN (PSYD, MFT, RN)
Entity type:Individual
Prefix:DR
First Name:JUDITH ANN
Middle Name:
Last Name:WILKIN
Suffix:
Gender:F
Credentials:PSYD, MFT, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1609 PACIFIC DR
Mailing Address - Street 2:
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95616-1332
Mailing Address - Country:US
Mailing Address - Phone:530-759-0463
Mailing Address - Fax:
Practice Address - Street 1:2200 L ST
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-4927
Practice Address - Country:US
Practice Address - Phone:916-498-9294
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA42793106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist