Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 28135 | CA |
Y | 103T00000X | Psychologist | 28135 | CA |
NPI | 1013300102 |
---|---|
Provider Name | Carol Woods |
First Address | Paso Robles, CA 93446-4845 |
Second Address | Paso Robles, CA 93446-4845 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/03/2015 |
Last Update Date | 25/03/2016 |