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General NPI Number Information
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NPI Number | 1609956259
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Entity Type | Individual
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Provider Name | MARIFE ENRIQUEZ WOODS PA
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Gender | Female
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Dates
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Enumeration Date | 10/17/2006
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Last Update Date | 09/27/2021
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Provider Practice Location Address
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Address Line | 2540 EAST ST
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City | CONCORD
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State | CA
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Zip | 94520-1906
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Country | US
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Telephone | 925-674-2241
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Fax |
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Provider Business Mailing Address
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Address Line | 218 BUCK CREEK CT
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City | MARTINEZ
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State | CA
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Zip | 94553-9678
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Country | US
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Telephone | 925-876-7855
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 007328
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License Number State | NY
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