Provider Demographics
NPI:1619001096
Name:WOODLAND, MARIA CONSUELO (LMFT)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:CONSUELO
Last Name:WOODLAND
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:MS
Other - First Name:MARIA
Other - Middle Name:CONSUELO
Other - Last Name:DUARTE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMFT
Mailing Address - Street 1:300 RANCHEROS DR STE 130
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:CA
Mailing Address - Zip Code:92069-2968
Mailing Address - Country:US
Mailing Address - Phone:760-279-1223
Mailing Address - Fax:
Practice Address - Street 1:380 S MELROSE DR STE 103
Practice Address - Street 2:
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92081-6656
Practice Address - Country:US
Practice Address - Phone:760-643-4096
Practice Address - Fax:760-643-4087
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17146106H00000X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health