Provider Demographics
NPI:1871917393
Name:WOOD, PATRICIA (RN, FNP-BC)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:WOOD
Suffix:
Gender:F
Credentials:RN, FNP-BC
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:
Other - Last Name:WOOD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN, FNP-BC
Mailing Address - Street 1:PO BOX 3441
Mailing Address - Street 2:
Mailing Address - City:SOUTH PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91031-6441
Mailing Address - Country:US
Mailing Address - Phone:626-298-2909
Mailing Address - Fax:
Practice Address - Street 1:1041 FOOTHILL ST
Practice Address - Street 2:
Practice Address - City:SOUTH PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91030-1717
Practice Address - Country:US
Practice Address - Phone:626-441-0687
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-05
Last Update Date:2015-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA289005163W00000X
1744R1102X
CA5320363LF0000X
CA26800364SC1501X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No1744R1102XOther Service ProvidersSpecialistResearch Study
No364SC1501XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistCommunity Health/Public Health