Provider Demographics
NPI:1992982383
Name:WOODWARD, BRIAN M (BA PSY)
Entity type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:M
Last Name:WOODWARD
Suffix:
Gender:M
Credentials:BA PSY
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:330 S MAGNOLIA AVE
Mailing Address - Street 2:SUITE 302
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92020-5290
Mailing Address - Country:US
Mailing Address - Phone:619-442-5434
Mailing Address - Fax:619-442-5451
Practice Address - Street 1:330 S MAGNOLIA AVE
Practice Address - Street 2:SUITE 302
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92020-5290
Practice Address - Country:US
Practice Address - Phone:619-442-5434
Practice Address - Fax:619-442-5451
Is Sole Proprietor?:No
Enumeration Date:2008-01-28
Last Update Date:2008-01-28
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health