Provider Demographics
NPI:1801775051
Name:WOODMAN, SHELLEY S
Entity type:Individual
Prefix:
First Name:SHELLEY
Middle Name:S
Last Name:WOODMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28920 OAK CREEK LN APT 1913
Mailing Address - Street 2:
Mailing Address - City:AGOURA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91301-6453
Mailing Address - Country:US
Mailing Address - Phone:415-793-5395
Mailing Address - Fax:
Practice Address - Street 1:650 HAMPSHIRE RD STE 200
Practice Address - Street 2:
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91361-2540
Practice Address - Country:US
Practice Address - Phone:805-601-6700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-01
Last Update Date:2025-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA115665101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health