Provider Demographics
NPI:1699108241
Name:WOODS, PEGGY ELLA (DAOM)
Entity type:Individual
Prefix:DR
First Name:PEGGY
Middle Name:ELLA
Last Name:WOODS
Suffix:
Gender:F
Credentials:DAOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 DONDEE ST STE 13
Mailing Address - Street 2:
Mailing Address - City:PACIFICA
Mailing Address - State:CA
Mailing Address - Zip Code:94044-3267
Mailing Address - Country:US
Mailing Address - Phone:650-273-8272
Mailing Address - Fax:650-952-3725
Practice Address - Street 1:450 DONDEE ST STE 13
Practice Address - Street 2:
Practice Address - City:PACIFICA
Practice Address - State:CA
Practice Address - Zip Code:94044-3267
Practice Address - Country:US
Practice Address - Phone:650-273-8272
Practice Address - Fax:650-952-3725
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-19
Last Update Date:2013-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 10755171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist