Healthcare Provider Details

I. General information

NPI: 1396420972
Provider Name (Legal Business Name): MARGARET ANNE NAM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MARGARET ANNE WOODWORTH MS

II. Dates (important events)

Enumeration Date: 06/20/2023
Last Update Date: 02/27/2025
Certification Date: 02/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 1762
GOLETA CA
93116-1762
US

IV. Provider business mailing address

PO BOX 1762
GOLETA CA
93116-1762
US

V. Phone/Fax

Practice location:
  • Phone: 805-703-4082
  • Fax:
Mailing address:
  • Phone: 805-703-4082
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPCC14629
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMHC312
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: