Provider Demographics
NPI:1386487007
Name:SMALL-WOODS, CHELSEA SAMANTHA (MS, RD)
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:SAMANTHA
Last Name:SMALL-WOODS
Suffix:
Gender:F
Credentials:MS, RD
Other - Prefix:
Other - First Name:CHELSEA
Other - Middle Name:SAMANTHA
Other - Last Name:WOODS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS, RD
Mailing Address - Street 1:12665 VILLAGE LN APT 4211
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90094-2856
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3724 JEFFERSON ST STE 104
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-6204
Practice Address - Country:US
Practice Address - Phone:512-692-7045
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-18
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered