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1245000827 NPI number — MATILDA MARQUEZ DE WOODARD CADTP 16441

NPI Number: 1245000827
Health Care Provider/Practitioner: MATILDA MARQUEZ DE WOODARD CADTP 16441

Information about “1245000827” NPI (MATILDA MARQUEZ DE WOODARD CADTP 16441) exists in 1245000827 in HTML format HTML  |  1245000827 in plain Text format TXT  |  1245000827 in PDF (Portable Document Format) PDF  |  1245000827 in an XML format XML  formats.

NPI Number : 1245000827 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1245000827",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MARQUEZ DE WOODARD",
    "FirstName": "MATILDA",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "CADTP 16441",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "2445 W WHITES BRIDGE AVE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "FRESNO",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "93706-1225",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "559-264-5096",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "2445 W WHITES BRIDGE AVE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "FRESNO",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "93706-1225",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "559-264-5096",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "01/04/2024",
    "LastUpdateDate": "05/14/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "101YA0400X",
        "TaxonomyName": "Addiction (Substance Use Disorder) Counselor",
        "LicenseNumber": "16441",
        "LicenseNumberStateCode": "CA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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