Basic Information
| Provider Information | |||||||||
| NPI: | 1528277373 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WOLF | ||||||||
| FirstName: | VICTORIA | ||||||||
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| Credential: | CATC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 201 S MILLER ST | ||||||||
| Address2: | SUITE 101 & 102 | ||||||||
| City: | SANTA MARIA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 934545233 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8059259811 | ||||||||
| FaxNumber: | 8059259706 | ||||||||
| Practice Location | |||||||||
| Address1: | 201 S MILLER ST | ||||||||
| Address2: | SUITE 101 & 102 | ||||||||
| City: | SANTA MARIA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 934545233 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8059259811 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/21/2007 | ||||||||
| LastUpdateDate: | 08/25/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | 020583 | CA | Y | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) |
No ID Information.