Provider Demographics
NPI:1992338479
Name:WOODS, RYAN WAYNE (DPT)
Entity type:Individual
Prefix:DR
First Name:RYAN
Middle Name:WAYNE
Last Name:WOODS
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1912 MUNSON ST
Mailing Address - Street 2:
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93010-3622
Mailing Address - Country:US
Mailing Address - Phone:214-535-3038
Mailing Address - Fax:
Practice Address - Street 1:231 CAMARILLO RANCH RD
Practice Address - Street 2:
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93012-5082
Practice Address - Country:US
Practice Address - Phone:805-484-2026
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-13
Last Update Date:2020-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA225100000X
CA298106225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist