Provider Demographics
NPI:1760439269
Name:WOODFORD, GINA ZIRPOLI (PHD)
Entity Type:Individual
Prefix:DR
First Name:GINA
Middle Name:ZIRPOLI
Last Name:WOODFORD
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:GINA
Other - Middle Name:GRACE
Other - Last Name:ZIRPOLI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:PO BOX 609001
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92160-9001
Mailing Address - Country:US
Mailing Address - Phone:619-528-4600
Mailing Address - Fax:619-528-4625
Practice Address - Street 1:3636 4TH AVE STE 304
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-4294
Practice Address - Country:US
Practice Address - Phone:619-498-5454
Practice Address - Fax:619-498-5455
Is Sole Proprietor?:No
Enumeration Date:2006-05-28
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY19113103T00000X
TX36420103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW416Medicare PIN
CACP19113Medicare PIN