Provider Demographics
NPI:1427207679
Name:WILLHOIT, WENDY VIRGINIA
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:VIRGINIA
Last Name:WILLHOIT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:WENDY
Other - Middle Name:VIRGINIA
Other - Last Name:HUFFMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:121 RANCHO DR UNIT A
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95111-4452
Mailing Address - Country:US
Mailing Address - Phone:408-509-6316
Mailing Address - Fax:
Practice Address - Street 1:90 GREAT OAKS BLVD
Practice Address - Street 2:SUITE 108
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95119-1314
Practice Address - Country:US
Practice Address - Phone:408-281-0708
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-11
Last Update Date:2008-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)