MEDICARE: DR. ERIKA WOODSON D.D.S

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	57552	CA

General Provider Information

NPI Number	:	1477700458
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERIKA WOODSON D.D.S

Provider Business Mailing Address
First Line	:	15301 WARREN SHINGLE RD
Second Line	:
City	:	BEALE AFB
State	:	CA
Zip	:	95903-1905
Country	:	US
Telephone Number	:	530-634-4781
Fax Number	:	530-634-4763

Provider Business Practice Location Address
First Line	:	15301 WARREN SHINGLE RD
Second Line	:
City	:	BEALE AFB
State	:	CA
Zip	:	95903-1905
Country	:	US
Telephone Number	:	530-634-4781
Fax Number	:	530-634-4763

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/21/2008
Last Update Date	:	10/15/2021

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