Healthcare Provider Details

I. General information

NPI: 1376568618
Provider Name (Legal Business Name): DAWN WOODS O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 07/24/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5300 HOLLISTER AVE
SANTA BARBARA CA
93111-2306
US

IV. Provider business mailing address

5300 HOLLISTER AVE
SANTA BARBARA CA
93111-2306
US

V. Phone/Fax

Practice location:
  • Phone: 805-692-6977
  • Fax: 805-692-6987
Mailing address:
  • Phone: 805-692-6977
  • Fax: 805-692-6987

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number07390T
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: