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General NPI Number Information
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NPI Number | 1720480130
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Entity Type | Organization
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Legal Business Name | ROSEMARY WOOD LMFT
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Dates
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Enumeration Date | 09/17/2014
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Last Update Date | 09/17/2014
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Provider Practice Location Address
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Address Line | 1425 LEIMERT BLVD SUITE 202
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City | OAKLAND
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State | CA
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Zip | 94602-1865
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Country | US
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Telephone | 510-708-7340
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Fax |
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Provider Business Mailing Address
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Address Line | 3045 FRYE ST
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City | OAKLAND
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State | CA
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Zip | 94602-4038
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Country | US
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Telephone | 510-708-7340
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Fax |
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Authorized Official
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Title or Position | PSYCHOTHERAPIST
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Name | MS. ROSEMARY RUSTON WOOD
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Credential | MA LMFT
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Telephone | 510-708-7340
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | MFC52648
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License Number State | CA
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