Provider Demographics
NPI:1639315351
Name:WOODS, BRENDA MARIE
Entity Type:Individual
Prefix:MRS
First Name:BRENDA
Middle Name:MARIE
Last Name:WOODS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11234 VALLEY BLVD
Mailing Address - Street 2:
Mailing Address - City:EL MONTE
Mailing Address - State:CA
Mailing Address - Zip Code:91731-3241
Mailing Address - Country:US
Mailing Address - Phone:626-575-4001
Mailing Address - Fax:626-579-7214
Practice Address - Street 1:11234 VALLEY BLVD
Practice Address - Street 2:
Practice Address - City:EL MONTE
Practice Address - State:CA
Practice Address - Zip Code:91731-3241
Practice Address - Country:US
Practice Address - Phone:626-575-4001
Practice Address - Fax:626-579-7214
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-30
Last Update Date:2008-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator