Provider Demographics
NPI:1013035252
Name:WOODEN, FEEBY JOE (PHD)
Entity Type:Individual
Prefix:DR
First Name:FEEBY
Middle Name:JOE
Last Name:WOODEN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4346
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92052-4346
Mailing Address - Country:US
Mailing Address - Phone:760-810-1440
Mailing Address - Fax:760-444-3297
Practice Address - Street 1:3355 MISSION AVE STE 111
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92058-1327
Practice Address - Country:US
Practice Address - Phone:760-810-1440
Practice Address - Fax:760-444-3297
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
CA26436103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)