Kenneth R. Wulff, MD

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

G32683 Issued in CA

Practice address

1503 Spring Hill Rd
Petaluma, CA 94952-9305

Phone

(707) 559-3895

NPI assigned

Oct 31, 2006

Last updated

Jan 18, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

Other, 1975

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Hope ServicesGroup PAC ID 5597716233, 29 clinicians

Thinh Duy Mai MD ApcGroup PAC ID 5698093581, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Hope Services

  • Community/Behavioral Health Agency
  • San Jose, CA
  • NPI 1861445306
  Medicare reassignment Care Compare group NPD
• Thinh Duy Mai M.D., a.P.C.

  • Psychiatry Physician
  • San Jose, CA
  • NPI 1770905945
  Medicare reassignment Care Compare group NPD
• Community Solutions for Children, Families and Individuals

  dba Community Solutions

  • Community/Behavioral Health Agency
  • Morgan Hill, CA
  • NPI 1720205131
  Medicare reassignment NPD
• Telecare Corporation

  dba Gateway To Recovery

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • San Diego, CA
  • NPI 1720164882
  Medicare reassignment NPD
• Community Solutions for Children, Families and Individuals

  dba La Casa Del Puente

  • Community/Behavioral Health Agency
  • Morgan Hill, CA
  • NPI 1386868107
  NPD
• Community Solutions for Children, Families and Individuals

  • Community/Behavioral Health Agency
  • San Jose, CA
  • NPI 1699927319
  NPD
• Hope Services

  • Community/Behavioral Health Agency
  • Mountain View, CA
  • NPI 1043571730
  NPD
• Telecare Corporation

  dba Valley Vista Permanent Supportive Housing

  • Mental Illness Community Based Residential Treatment Facility
  • San Diego, CA
  • NPI 1275398935
  NPD
• Telecare Corporation

  dba AMHS TAO Central FSP

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Garden Grove, CA
  • NPI 1346737590
  NPD
• Duke D. Fisher, MD Inc

  • Psychiatry Physician
  • San Jose, CA
  • NPI 1487759205
  NPD (past)
• Puentes Al Sur

  dba Health Services Agency-Mental Health Division

  • Adult Mental Health Clinic/Center
  • Watsonville, CA
  • NPI 1992849012
  NPD (past)
• Rite of Passage Adolescent Treatment Centers and Schools, Inc.

  • Adolescent and Children Mental Health Clinic/Center
  • Torrance, CA
  • NPI 1003391467
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705536000000",
    "number": "1124105085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1503 SPRING HILL RD",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949529305",
            "telephone_number": "707-559-3895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1503 SPRING HILL RD",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949529305",
            "telephone_number": "707-559-3895"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "537 W 8th St",
            "address_purpose": "LOCATION",
            "city": "San Pedro",
            "state": "CA",
            "postal_code": "907313119",
            "country_code": "US",
            "telephone_number": "310-834-1198",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "250 Joann St",
            "address_purpose": "LOCATION",
            "city": "Costa Mesa",
            "state": "CA",
            "postal_code": "926266455",
            "country_code": "US",
            "telephone_number": "949-631-9045",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1597 Baker St",
            "address_purpose": "LOCATION",
            "city": "Costa Mesa",
            "state": "CA",
            "postal_code": "926263746",
            "country_code": "US",
            "telephone_number": "714-435-7940",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1691 Gramercy Ave",
            "address_purpose": "LOCATION",
            "city": "Torrance",
            "state": "CA",
            "postal_code": "905013236",
            "country_code": "US",
            "telephone_number": "310-320-0195",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WULFF",
        "first_name": "KENNETH",
        "middle_name": "R.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-31",
        "last_updated": "2024-01-18",
        "certification_date": "2024-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CA",
            "license": "G32683",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G326830",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Morgan Taylor Wright Johnson
• Daniel L Wrightsman, MA, MFTI
• Wroten Chiropractic Incorporated (Serendipity Chiropractic)
• Jeremy Wroten, DC
• James Jerome Wu, MD
• Lorena Yanez-Ramirez, ACSW
• Jocelyne Yanez
• Wilyza Mae Olorvida Yap
• Patricia Sue Yardley
• Thelonius Stephen Ferland Yardley

• Child & Adolescent Psychiatry Physician in Petaluma, CA
• Providers in Petaluma, CA by specialty
• Child & Adolescent Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.