Provider Demographics
NPI:1518969179
Name:WOODS, ELIZABETH ANNE (NP)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:ANNE
Last Name:WOODS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:BETTY
Other - Middle Name:ANNE
Other - Last Name:WOODS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:173 VINEYARD CIR
Mailing Address - Street 2:
Mailing Address - City:SONOMA
Mailing Address - State:CA
Mailing Address - Zip Code:95476-8043
Mailing Address - Country:US
Mailing Address - Phone:707-799-0645
Mailing Address - Fax:707-933-8265
Practice Address - Street 1:490 CITY CENTER DRIVE
Practice Address - Street 2:
Practice Address - City:ROHNERT PARK
Practice Address - State:CA
Practice Address - Zip Code:94928-2178
Practice Address - Country:US
Practice Address - Phone:707-585-7780
Practice Address - Fax:707-585-7784
Is Sole Proprietor?:No
Enumeration Date:2005-08-12
Last Update Date:2012-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA176350363L00000X
CA1091363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner