| Kenneth Wiseman, | |
|
838 Beach Court, Lotus, CA 95651 | |
| (530) 626-7252 | |
| Not Available |
| Full Name | Kenneth Wiseman |
|---|---|
| Gender | Male |
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 838 Beach Court, Lotus, California |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053905752 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | R1420310221 (California) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Kenneth Wiseman, 2844 Coloma St, Placerville, CA 95667-4406 Ph: (530) 626-9240 | Kenneth Wiseman, 838 Beach Court, Lotus, CA 95651 Ph: (530) 626-7252 |
Lucas Michael Mcroberts, RADT Counselor Medicare: Not Enrolled in Medicare Practice Location: 838 Beach Ct, Lotus, CA 95651 Phone: 530-626-7252 | |
Tom Allen Clark, Counselor Medicare: Not Enrolled in Medicare Practice Location: 838 Beach Court, Lotus, CA 95633 Phone: 530-626-7252 | |
Daniel Lawrence Gilliland, SUDCC Counselor Medicare: Not Enrolled in Medicare Practice Location: 838 Beach Court, Lotus, CA 95633 Phone: 530-626-7252 | |
Anthony James Gonzalez, RADT1 Counselor Medicare: Not Enrolled in Medicare Practice Location: 838 Beach Ct, Lotus, CA 95651 Phone: 530-626-7383 | |
Daniel Alexander Brandon, Counselor Medicare: Not Enrolled in Medicare Practice Location: 838 Beach Ct, Lotus, CA 95651 Phone: 530-626-7252 | |
Brangwyn Ursula Foley, Counselor Medicare: Not Enrolled in Medicare Practice Location: 838 Beach Court, Lotus, CA 95651 Phone: 530-626-7252 |