Colleen Woodard, CDAC-1

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CICA00670319 Issued in CA

Practice address

31764 Casino Dr Ste 200
Lake Elsinore, CA 92530-2312

Phone

(909) 573-7618

NPI assigned

Aug 14, 2014

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1407974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726617600000",
    "number": "1154720183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23119 COTTONWOOD AVE",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925539661",
            "telephone_number": "951-413-5130",
            "fax_number": "951-413-5230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31764 CASINO DR STE 200",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925302312",
            "telephone_number": "909-573-7618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODARD",
        "first_name": "COLLEEN",
        "credential": "CDAC-1",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-14",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "CICA00670319",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "CA",
            "license": "CICA00670319",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Biplav Yadav, MD
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• Addiction (Substance Use Disorder) Counselor in Lake Elsinore, CA
• Providers in Lake Elsinore, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.