Healthcare Provider Details

I. General information

NPI: 1699663443
Provider Name (Legal Business Name): JENNIFER ROSE WOODS TYLER AU.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER ROSE WOODS

II. Dates (important events)

Enumeration Date: 06/27/2025
Last Update Date: 06/27/2025
Certification Date: 06/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

975 SERENO DR
VALLEJO CA
94589-2441
US

IV. Provider business mailing address

1743 TUOLUMNE ST
VALLEJO CA
94589-2618
US

V. Phone/Fax

Practice location:
  • Phone: 707-651-1000
  • Fax:
Mailing address:
  • Phone: 707-567-1316
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: