Provider Demographics
NPI:1447241948
Name:WOOD, KATHLEEN P (RN-CFNP)
Entity Type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:P
Last Name:WOOD
Suffix:
Gender:F
Credentials:RN-CFNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:532 MERIDIAN AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91030-1736
Mailing Address - Country:US
Mailing Address - Phone:626-441-8482
Mailing Address - Fax:
Practice Address - Street 1:4448 YORK BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90041-3328
Practice Address - Country:US
Practice Address - Phone:323-344-5233
Practice Address - Fax:323-344-5237
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA153988363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily