Healthcare Provider Details

I. General information

NPI: 1770463564
Provider Name (Legal Business Name): WENDY MARIE WOODBURN PPS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2025
Last Update Date: 09/03/2025
Certification Date: 09/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10535 ZELZAH AVE
GRANADA HILLS CA
91344-5902
US

IV. Provider business mailing address

10535 ZELZAH AVE
GRANADA HILLS CA
91344-5902
US

V. Phone/Fax

Practice location:
  • Phone: 818-360-2361
  • Fax: 818-363-2694
Mailing address:
  • Phone: 818-360-2361
  • Fax: 818-363-2694

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: