Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | ||
Y | 103G00000X | Clinical Psychologist | 26436 | CA |
Y | 103TC0700X | Clinical Psychologist | 26436 | CA |
NPI | 1013035252 |
---|---|
Provider Name | Dr. Feeby Joe Wooden |
First Address | Oceanside, CA 92052-4346 |
Second Address | Oceanside, CA 92058-1327 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2007 |
Last Update Date | 17/03/2018 |