Healthcare Provider Details

I. General information

NPI: 1942028972
Provider Name (Legal Business Name): NATALIE JANELLY WOODRUFF PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2024
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 S GLENDORA AVE
WEST COVINA CA
91790-3001
US

IV. Provider business mailing address

420 S GLENDORA AVE
WEST COVINA CA
91790-3001
US

V. Phone/Fax

Practice location:
  • Phone: 626-919-4333
  • Fax:
Mailing address:
  • Phone: 626-919-4333
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: