Provider Demographics
NPI:1073880787
Name:WOODS, MARISA (NP)
Entity Type:Individual
Prefix:
First Name:MARISA
Middle Name:
Last Name:WOODS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 BON AIR CTR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:GREENBRAE
Mailing Address - State:CA
Mailing Address - Zip Code:94904-3000
Mailing Address - Country:US
Mailing Address - Phone:415-578-3095
Mailing Address - Fax:415-291-0489
Practice Address - Street 1:350 BON AIR CTR
Practice Address - Street 2:SUITE 200
Practice Address - City:GREENBRAE
Practice Address - State:CA
Practice Address - Zip Code:94904-3000
Practice Address - Country:US
Practice Address - Phone:415-578-3095
Practice Address - Fax:415-291-0489
Is Sole Proprietor?:No
Enumeration Date:2011-11-23
Last Update Date:2016-10-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA756819363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner