Provider Demographics
NPI:1780710160
Name:WOOLEY, EDWARD CHARLES (RN, CCP)
Entity type:Individual
Prefix:MR
First Name:EDWARD
Middle Name:CHARLES
Last Name:WOOLEY
Suffix:
Gender:M
Credentials:RN, CCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8733 MCCARTY RANCH DR
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95135-2156
Mailing Address - Country:US
Mailing Address - Phone:408-528-1117
Mailing Address - Fax:408-528-1118
Practice Address - Street 1:8733 MCCARTY RANCH DR
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95135-2156
Practice Address - Country:US
Practice Address - Phone:408-528-1117
Practice Address - Fax:408-528-1118
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other