Provider Demographics
NPI:1083329049
Name:KOHLHASE, WENDY WENDY
Entity Type:Individual
Prefix:DR
First Name:WENDY
Middle Name:WENDY
Last Name:KOHLHASE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:931 S EL MOLINO AVE
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91106-4413
Mailing Address - Country:US
Mailing Address - Phone:626-823-1103
Mailing Address - Fax:
Practice Address - Street 1:931 S EL MOLINO AVE
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91106-4413
Practice Address - Country:US
Practice Address - Phone:626-823-1103
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-13
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174V00000XOther Service ProvidersClinical Ethicist