Provider Demographics
NPI:1376886697
Name:SHEFFER-WOODWARD, TAMMY L (MA, LLM, PSYD)
Entity Type:Individual
Prefix:DR
First Name:TAMMY
Middle Name:L
Last Name:SHEFFER-WOODWARD
Suffix:
Gender:F
Credentials:MA, LLM, PSYD
Other - Prefix:DR
Other - First Name:TAMERAH
Other - Middle Name:L
Other - Last Name:WOODWARD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA, LLM, PSYD
Mailing Address - Street 1:2115 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94601-4335
Mailing Address - Country:US
Mailing Address - Phone:209-475-8792
Mailing Address - Fax:
Practice Address - Street 1:2115 HIGH ST
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94601-4335
Practice Address - Country:US
Practice Address - Phone:209-475-8792
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-04
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL032312101Y00000X
101YM0800X, 172V00000X
CAPLW101YP2500X, 103T00000X
CA131790225C00000X
CA251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No172V00000XOther Service ProvidersCommunity Health Worker
No225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor
No251S00000XAgenciesCommunity/Behavioral Health