Provider Demographics
NPI:1609101757
Name:WOODS, TONI INA (CAS, FACT)
Entity Type:Individual
Prefix:MRS
First Name:TONI
Middle Name:INA
Last Name:WOODS
Suffix:
Gender:F
Credentials:CAS, FACT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4125 ALPHA ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92113-4544
Mailing Address - Country:US
Mailing Address - Phone:619-668-4200
Mailing Address - Fax:619-698-1663
Practice Address - Street 1:4125 ALPHA ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92113-4544
Practice Address - Country:US
Practice Address - Phone:619-698-4200
Practice Address - Fax:619-698-1663
Is Sole Proprietor?:No
Enumeration Date:2009-10-07
Last Update Date:2010-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA01-077506101YA0400X
CA389101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)