Wood, Sally Medora

Wood, Sally Medora is an individual health care provider with primary practice located at 604 3Rd St , Davis CA 95616-4553. She recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as her primary health care specialty. Wood, Sally Medora can be contacted via phone (530) 756-8754.

Contact Information

Primary practice address
604 3Rd St Davis CA 95616-4553
Phone: (530) 756-8754
Fax: (530) 297-0766
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X PSY 10277 California

Profile Details

NPI number 1578528386
LBN Legal business name Wood, Sally Medora
Credentials PH.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 18th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1578528386 NPPES
California Other 7290-01 PACIFICARE
California Other 61-73217 PACIFICARE
California Other 680307290T4B2AU PACIFICARE
California Other 0001010300 PACIFICARE
California Other A792509 PACIFICARE
California Other OPL102770 PACIFICARE

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