Provider Demographics
NPI:1790188811
Name:WOODSON, CHERYL ANN (DPT)
Entity Type:Individual
Prefix:DR
First Name:CHERYL
Middle Name:ANN
Last Name:WOODSON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:230 S CATALINA AVE APT 305
Mailing Address - Street 2:
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90277-3365
Mailing Address - Country:US
Mailing Address - Phone:310-710-2848
Mailing Address - Fax:
Practice Address - Street 1:28924 S WESTERN AVE STE 101
Practice Address - Street 2:
Practice Address - City:RANCHO PALOS VERDES
Practice Address - State:CA
Practice Address - Zip Code:90275-0813
Practice Address - Country:US
Practice Address - Phone:310-548-0104
Practice Address - Fax:310-548-0559
Is Sole Proprietor?:No
Enumeration Date:2014-10-02
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 35536225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist