Provider Demographics
NPI:1497308415
Name:WOODS, ALYSHA (MSN, PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:ALYSHA
Middle Name:
Last Name:WOODS
Suffix:
Gender:F
Credentials:MSN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:161 W ALTADENA DR # 1001
Mailing Address - Street 2:
Mailing Address - City:ALTADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91001-4735
Mailing Address - Country:US
Mailing Address - Phone:818-809-0991
Mailing Address - Fax:
Practice Address - Street 1:507 W FOOTHILL BLVD # D
Practice Address - Street 2:
Practice Address - City:MONROVIA
Practice Address - State:CA
Practice Address - Zip Code:91016-2021
Practice Address - Country:US
Practice Address - Phone:818-809-0991
Practice Address - Fax:818-533-9540
Is Sole Proprietor?:No
Enumeration Date:2019-07-18
Last Update Date:2022-09-07
Deactivation Date:2022-08-15
Deactivation Code:
Reactivation Date:2022-09-07
Provider Licenses
StateLicense IDTaxonomies
CA95012235363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA95012235OtherNURSE PRACTITIONER