Provider Demographics
NPI:1619572120
Name:WOODS, SHEREE (SLP)
Entity Type:Individual
Prefix:
First Name:SHEREE
Middle Name:
Last Name:WOODS
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2530 DOUGLAS BLVD STE 110
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-3990
Mailing Address - Country:US
Mailing Address - Phone:916-797-3307
Mailing Address - Fax:916-415-2115
Practice Address - Street 1:2530 DOUGLAS BLVD STE 110
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-3990
Practice Address - Country:US
Practice Address - Phone:916-797-3307
Practice Address - Fax:916-415-2115
Is Sole Proprietor?:No
Enumeration Date:2020-12-02
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8518235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist