Provider Demographics
NPI:1497538342
Name:WOODIN, SHELDON
Entity Type:Individual
Prefix:
First Name:SHELDON
Middle Name:
Last Name:WOODIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 STINE RD
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-4161
Mailing Address - Country:US
Mailing Address - Phone:661-617-6040
Mailing Address - Fax:
Practice Address - Street 1:1300 STINE RD
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-4161
Practice Address - Country:US
Practice Address - Phone:661-617-6040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-15
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician