Provider Demographics
NPI:1417595711
Name:WOODS, ALEXIS MOZELLE LOLITA (PHARMD)
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:MOZELLE LOLITA
Last Name:WOODS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5348 E HEATON AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93727-5252
Mailing Address - Country:US
Mailing Address - Phone:559-283-3680
Mailing Address - Fax:
Practice Address - Street 1:5348 E HEATON AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93727-5252
Practice Address - Country:US
Practice Address - Phone:559-283-3680
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-17
Last Update Date:2019-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND81513183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist