Provider Demographics
NPI:1164620571
Name:WOODLAND, ERICA NICOLE (LCSW)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:NICOLE
Last Name:WOODLAND
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7793
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94601-0793
Mailing Address - Country:US
Mailing Address - Phone:510-854-6551
Mailing Address - Fax:
Practice Address - Street 1:444 34TH ST STE 10
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-2816
Practice Address - Country:US
Practice Address - Phone:510-854-6551
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-06
Last Update Date:2018-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA269831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical