Provider Demographics
NPI:1467597815
Name:WOLMAN, CAROL STONE (MD)
Entity Type:Individual
Prefix:DR
First Name:CAROL
Middle Name:STONE
Last Name:WOLMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 1328
Mailing Address - Street 2:
Mailing Address - City:MENDOCINO
Mailing Address - State:CA
Mailing Address - Zip Code:95460-1328
Mailing Address - Country:US
Mailing Address - Phone:707-937-2468
Mailing Address - Fax:510-655-4774
Practice Address - Street 1:225 CLIFTON ST
Practice Address - Street 2:APT 212
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94618-1774
Practice Address - Country:US
Practice Address - Phone:510-452-9946
Practice Address - Fax:510-452-9946
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2021-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG175072084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG17507OtherLICENSE #
CAG17507OtherLICENSE #
CAN40098Medicare UPIN