Provider Demographics
NPI:1720016165
Name:WOODWARD, QUY-TRAN PHI (MA, CCC-A)
Entity Type:Individual
Prefix:MRS
First Name:QUY-TRAN
Middle Name:PHI
Last Name:WOODWARD
Suffix:
Gender:F
Credentials:MA, CCC-A
Other - Prefix:
Other - First Name:QUY-TRAN
Other - Middle Name:HONG
Other - Last Name:PHI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:FILE #55745
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90074-5745
Mailing Address - Country:US
Mailing Address - Phone:818-768-6447
Mailing Address - Fax:818-768-6888
Practice Address - Street 1:8341 LAUREL CANYON BLVD
Practice Address - Street 2:
Practice Address - City:SUN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:91352-3809
Practice Address - Country:US
Practice Address - Phone:818-768-6447
Practice Address - Fax:818-768-6888
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2009-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU2152231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWAU2152AMedicare PIN