Provider Demographics
NPI:1205029451
Name:WOODS, CASSANDRA COLLEEN (PT)
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:COLLEEN
Last Name:WOODS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:CASSIE
Other - Middle Name:COLLEEN
Other - Last Name:WOODS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:1827 KNOLL DR
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-7321
Mailing Address - Country:US
Mailing Address - Phone:805-667-8200
Mailing Address - Fax:805-667-8200
Practice Address - Street 1:1827 KNOLL DR
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-7321
Practice Address - Country:US
Practice Address - Phone:805-667-8200
Practice Address - Fax:805-667-8200
Is Sole Proprietor?:No
Enumeration Date:2007-08-21
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 26089225100000X, 2251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist