Healthcare Provider Details

I. General information

NPI: 1134359540
Provider Name (Legal Business Name): JANINE WOODS R.N., P.H.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2009
Last Update Date: 07/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 BEETHOVEN CMN #100
FREMONT CA
94538-4624
US

IV. Provider business mailing address

1010 BEETHOVEN CMN #100
FREMONT CA
94538-4624
US

V. Phone/Fax

Practice location:
  • Phone: 510-938-9650
  • Fax: 510-744-9792
Mailing address:
  • Phone: 510-938-9650
  • Fax: 510-744-9792

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License NumberRN 459238
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberRN 459238
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: