Healthcare Provider Details

I. General information

NPI: 1376465310
Provider Name (Legal Business Name): SHELBIE WOOD M.A., CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10862 BLOOMFIELD ST
LOS ALAMITOS CA
90720-2505
US

IV. Provider business mailing address

772 MIRA MAR AVE APT 1
LONG BEACH CA
90804-5325
US

V. Phone/Fax

Practice location:
  • Phone: 714-816-3300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number37189
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: