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General NPI Number Information
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NPI Number | 1073710398
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Entity Type | Organization
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Legal Business Name | CALIFORNIA DEPARTMENT OF CORRECTIONS &REHABILITATION
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Dates
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Enumeration Date | 06/29/2007
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Last Update Date | 02/05/2009
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Provider Practice Location Address
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Address Line | 21633 AVENUE 24
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City | CHOWCHILLA
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State | CA
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Zip | 93610-0099
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Country | US
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Telephone | 559-665-6100
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Fax |
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Provider Business Mailing Address
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Address Line | 21633 AVENUE 24
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City | CHOWCHILLA
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State | CA
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Zip | 93610-0099
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Country | US
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Telephone | 559-665-6100
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | MS. BARBARA L. WOODWARD
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Credential | N.P.
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Telephone | 559-665-6100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number | RN#452501 N.P.#8290
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License Number State | CA
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