Provider Demographics
NPI:1699985556
Name:WOODLEY, STEPHEN ARTHUR (L AC)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:ARTHUR
Last Name:WOODLEY
Suffix:
Gender:M
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 RIO ROBLES E UNIT 1404
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95134-1653
Mailing Address - Country:US
Mailing Address - Phone:650-678-1102
Mailing Address - Fax:
Practice Address - Street 1:1550 THE ALAMEDA STE 130
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95126-2322
Practice Address - Country:US
Practice Address - Phone:650-678-1102
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2018-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC7389171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist