Provider Information for 1952030702
The following NPI(s) contain information matching your search criteria. Please select the NPI to view all the data associated with the NPI.
Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know
Mr. THEODORE JAMES WOODARD III MA, LPC
Sex: Male
NPI: 1952030702
Last Updated: 2024-06-13
Certification Date: 2024-06-13
Certification Date: 2024-06-13
Details
| Name | Value | ||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1952030702 | ||||||||||||||
| Enumeration Date | 2022-06-07 | ||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||
| Sole Proprietor | YES | ||||||||||||||
| Status | Active | ||||||||||||||
| Mailing Address | 2116 ARLINGTON AVE LOS ANGELES, CA 90018-1353 United States Phone: 323-334-9000 | Fax: | ||||||||||||||
| Primary Practice Address | 2116 ARLINGTON AVE LOS ANGELES, CA 90018-1353 United States Phone: 323-334-9000 | Fax: | ||||||||||||||
| Secondary Practice Address(es) | 9401 SOUTHWEST FWY | ||||||||||||||
| Health Information Exchange |
| ||||||||||||||
| Other Identifiers |
| ||||||||||||||
| Taxonomy |
|