Provider Demographics
NPI:1902599582
Name:WOO, MARY (FNP, MSN, RN, CNS)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:
Last Name:WOO
Suffix:
Gender:F
Credentials:FNP, MSN, RN, CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3221 GARFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-1713
Mailing Address - Country:US
Mailing Address - Phone:415-860-4057
Mailing Address - Fax:
Practice Address - Street 1:3221 GARFIELD AVE
Practice Address - Street 2:
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94501-1713
Practice Address - Country:US
Practice Address - Phone:415-860-4057
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-31
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA632605163WX0002X
CA2507364SW0102X
CA16439363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WX0002XNursing Service ProvidersRegistered NurseObstetric, High-Risk
No364SW0102XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistWomen's Health