Provider Demographics
NPI:1740615871
Name:WOOLSEY, MALIA RHIANNON KEHAUNANI (NP)
Entity Type:Individual
Prefix:
First Name:MALIA
Middle Name:RHIANNON KEHAUNANI
Last Name:WOOLSEY
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:145 VISTA AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91107-3607
Mailing Address - Country:US
Mailing Address - Phone:626-793-2885
Mailing Address - Fax:626-793-6262
Practice Address - Street 1:625 S FAIR OAKS AVE
Practice Address - Street 2:SUITE 215
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-2613
Practice Address - Country:US
Practice Address - Phone:626-793-4139
Practice Address - Fax:626-304-8280
Is Sole Proprietor?:No
Enumeration Date:2013-09-09
Last Update Date:2013-09-09
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Provider Licenses
StateLicense IDTaxonomies
CA23532363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner