Provider Demographics
NPI:1104018498
Name:WOODBURY, MARGARITA MERCEDES (MD)
Entity Type:Individual
Prefix:DR
First Name:MARGARITA
Middle Name:MERCEDES
Last Name:WOODBURY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2930 CAMINO DIABLO
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94597-3986
Mailing Address - Country:US
Mailing Address - Phone:925-938-3757
Mailing Address - Fax:
Practice Address - Street 1:2930 CAMINO DIABLO
Practice Address - Street 2:SUITE 200
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94597-3986
Practice Address - Country:US
Practice Address - Phone:925-938-3757
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-10
Last Update Date:2007-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG0683522084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry