Provider Demographics
NPI:1093593998
Name:HOOD, WILLEENA CLARICE (RN)
Entity Type:Individual
Prefix:MISS
First Name:WILLEENA
Middle Name:CLARICE
Last Name:HOOD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1549 PHOENIX DR
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:CA
Mailing Address - Zip Code:92223-7813
Mailing Address - Country:US
Mailing Address - Phone:562-726-6917
Mailing Address - Fax:
Practice Address - Street 1:1549 PHOENIX DR
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:CA
Practice Address - Zip Code:92223-7813
Practice Address - Country:US
Practice Address - Phone:562-726-6917
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-20
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95061873163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse