Provider Demographics
NPI:1083479745
Name:WOOTEN, ALMA L (ACSW)
Entity Type:Individual
Prefix:MS
First Name:ALMA
Middle Name:L
Last Name:WOOTEN
Suffix:
Gender:F
Credentials:ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5228 ADOBE RD APT N
Mailing Address - Street 2:
Mailing Address - City:TWENTYNINE PALMS
Mailing Address - State:CA
Mailing Address - Zip Code:92277-1883
Mailing Address - Country:US
Mailing Address - Phone:760-903-8179
Mailing Address - Fax:
Practice Address - Street 1:6601 WHITE FEATHER RD
Practice Address - Street 2:
Practice Address - City:JOSHUA TREE
Practice Address - State:CA
Practice Address - Zip Code:92252-6607
Practice Address - Country:US
Practice Address - Phone:760-366-6714
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-20
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1200281041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool