Healthcare Provider Details

I. General information

NPI: 1346300340
Provider Name (Legal Business Name): DAVID JAMES WOODLAND LPCC, CRC.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/11/2006
Last Update Date: 02/17/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 EMBARCADERO STE 400
OAKLAND CA
94606-5300
US

IV. Provider business mailing address

2000 EMBARCADERO STE 400
OAKLAND CA
94606-5300
US

V. Phone/Fax

Practice location:
  • Phone: 510-383-8527
  • Fax: 510-639-1346
Mailing address:
  • Phone: 510-383-8527
  • Fax: 510-639-1346

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number41
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number41
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: