Provider Demographics
NPI:1306454251
Name:WOODWARD, CHRISTIAN JON (RRT, RCP)
Entity type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:JON
Last Name:WOODWARD
Suffix:
Gender:M
Credentials:RRT, RCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 SERENO DR
Mailing Address - Street 2:
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94589-2411
Mailing Address - Country:US
Mailing Address - Phone:707-651-2318
Mailing Address - Fax:
Practice Address - Street 1:800 SERENO DR
Practice Address - Street 2:
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94589-2411
Practice Address - Country:US
Practice Address - Phone:707-651-2318
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-16
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA294692279P1005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2279P1005XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredPulmonary Rehabilitation