Provider Demographics
NPI:1407190481
Name:WOODRUFF, VICTORIA ANN (RRW)
Entity Type:Individual
Prefix:MR
First Name:VICTORIA
Middle Name:ANN
Last Name:WOODRUFF
Suffix:
Gender:F
Credentials:RRW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 TERRAINE ST FL 2
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95110-2423
Mailing Address - Country:US
Mailing Address - Phone:408-491-4723
Mailing Address - Fax:408-491-4895
Practice Address - Street 1:115 TERRAINE ST FL 2
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95110-2423
Practice Address - Country:US
Practice Address - Phone:408-491-4723
Practice Address - Fax:408-491-4895
Is Sole Proprietor?:No
Enumeration Date:2012-11-15
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)