Elissa Woodruff, PH.D.

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

License

PSY26236 Issued in CA

Practice address

820 Las Gallinas Ave
San Rafael, CA 94903-3410

Phone

(415) 491-3013

NPI assigned

Jun 10, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1402358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402358400000",
    "number": "1447663133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "988 FULTON ST",
            "address_2": "321",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941171770",
            "telephone_number": "972-345-6705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 LAS GALLINAS AVE",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949033410",
            "telephone_number": "415-491-3013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODRUFF",
        "first_name": "ELISSA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-10",
        "last_updated": "2014-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "CA",
            "license": "PSY26236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennea Wood, N.D.
• Darcy Woodall
• Michele Jan Woodbury, MA, PPSC
• Dorinda Woodley
• Tamsin June Woodmason, MSCP
• Briana Woods
• Patricia A Woods
• Daisy Wu
• Leslie Chiao-Yun Wu, PHARMD
• David Andrew Wurfel, MS

• Health Maintenance Organization in San Rafael, CA
• Providers in San Rafael, CA by specialty
• Health Maintenance Organization in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2014; 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.