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General NPI Number Information
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NPI Number | 1316451834
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Entity Type | Individual
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Provider Name | SHARRON WOODFORD - BEALE CADC CAS
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Gender | Female
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Dates
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Enumeration Date | 11/20/2017
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Last Update Date | 05/22/2024
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Provider Practice Location Address
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Address Line | 2275 E COOLEY DR
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City | COLTON
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State | CA
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Zip | 92324-6324
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Country | US
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Telephone | 909-370-1777
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Fax | 909-370-1776
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Provider Business Mailing Address
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Address Line | 9298 CITRUS AVE APT B
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City | FONTANA
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State | CA
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Zip | 92335-5581
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Country | US
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Telephone | 909-997-2066
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | C052070418
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License Number State |
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