Provider Demographics
NPI:1477522738
Name:WOODALL, LINDA (MD)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:WOODALL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:LEANN OREN
Other - Last Name:WOODALL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:200 E DEL MAR BLVD STE 122
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-2551
Mailing Address - Country:US
Mailing Address - Phone:626-360-2080
Mailing Address - Fax:626-360-2090
Practice Address - Street 1:200 E DEL MAR BLVD STE 122
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-2551
Practice Address - Country:US
Practice Address - Phone:266-360-2080
Practice Address - Fax:626-360-2090
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA698352084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry