Provider Demographics
NPI:1336488717
Name:WOOD, RANIA
Entity Type:Individual
Prefix:
First Name:RANIA
Middle Name:
Last Name:WOOD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17472 EASTERN PINES CT
Mailing Address - Street 2:
Mailing Address - City:CANYON COUNTRY
Mailing Address - State:CA
Mailing Address - Zip Code:91387-3899
Mailing Address - Country:US
Mailing Address - Phone:818-438-5444
Mailing Address - Fax:800-832-2321
Practice Address - Street 1:17472 EASTERN PINES CT
Practice Address - Street 2:
Practice Address - City:CANYON COUNTRY
Practice Address - State:CA
Practice Address - Zip Code:91387-3899
Practice Address - Country:US
Practice Address - Phone:818-438-5444
Practice Address - Fax:800-832-2321
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-05
Last Update Date:2013-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA0-11-4074103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral