Provider Demographics
NPI:1720480130
Name:ROSEMARY WOOD LMFT
Entity type:Organization
Organization Name:ROSEMARY WOOD LMFT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:ROSEMARY
Authorized Official - Middle Name:RUSTON
Authorized Official - Last Name:WOOD
Authorized Official - Suffix:
Authorized Official - Credentials:MA LMFT
Authorized Official - Phone:510-708-7340
Mailing Address - Street 1:3045 FRYE ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94602-4038
Mailing Address - Country:US
Mailing Address - Phone:510-708-7340
Mailing Address - Fax:
Practice Address - Street 1:1425 LEIMERT BLVD
Practice Address - Street 2:SUITE 202
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94602-1865
Practice Address - Country:US
Practice Address - Phone:510-708-7340
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-17
Last Update Date:2014-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC52648251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health