Provider Demographics
NPI:1073180840
Name:WOODS, FALLON W (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:FALLON
Middle Name:W
Last Name:WOODS
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:761 PLUMAS ST UNIT 933
Mailing Address - Street 2:
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95992-2140
Mailing Address - Country:US
Mailing Address - Phone:530-632-0329
Mailing Address - Fax:
Practice Address - Street 1:1215 PLUMAS ST STE 1200
Practice Address - Street 2:
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95991-3490
Practice Address - Country:US
Practice Address - Phone:530-632-0329
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-09
Last Update Date:2023-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA25531235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist