Healthcare Provider Details
I. General information
NPI: 1235837212
Provider Name (Legal Business Name): ALLISON MAE WOODWORTH PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 02/20/2023
Last Update Date: 09/26/2025
Certification Date: 09/26/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
250 W 5TH ST
HANFORD CA
93230-5029
US
IV. Provider business mailing address
250 W 5TH ST
HANFORD CA
93230-5029
US
V. Phone/Fax
- Phone: 877-960-3426
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363A00000X |
| Taxonomy | Physician Assistant |
| License Number | 62880 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: