Provider Demographics
NPI:1265174106
Name:WOOD, VALERIE R
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:R
Last Name:WOOD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1351 WOODSIDE GLEN WAY
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95833-1637
Mailing Address - Country:US
Mailing Address - Phone:916-730-7758
Mailing Address - Fax:
Practice Address - Street 1:50 W MAIN ST STE 110
Practice Address - Street 2:
Practice Address - City:WOODLAND
Practice Address - State:CA
Practice Address - Zip Code:95695-3083
Practice Address - Country:US
Practice Address - Phone:530-490-2020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-11
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator