Provider Demographics
NPI:1972956068
Name:WOODS, ALISHA
Entity type:Individual
Prefix:
First Name:ALISHA
Middle Name:
Last Name:WOODS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2865 CHURN CREEK RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96002-1117
Mailing Address - Country:US
Mailing Address - Phone:530-646-7269
Mailing Address - Fax:530-275-2201
Practice Address - Street 1:2865 CHURN CREEK RD
Practice Address - Street 2:SUITE A
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96002-1117
Practice Address - Country:US
Practice Address - Phone:530-646-7269
Practice Address - Fax:530-275-2201
Is Sole Proprietor?:No
Enumeration Date:2016-07-13
Last Update Date:2016-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSB94022660103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist