Provider Demographics
NPI:1548691728
Name:WOODS, VICKIE K (LMFT)
Entity type:Individual
Prefix:
First Name:VICKIE
Middle Name:K
Last Name:WOODS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1026 BLUESAGE DR
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:CA
Mailing Address - Zip Code:92078-5241
Mailing Address - Country:US
Mailing Address - Phone:760-845-3887
Mailing Address - Fax:
Practice Address - Street 1:741 GARDEN VIEW CT
Practice Address - Street 2:SUITE 210
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-2470
Practice Address - Country:US
Practice Address - Phone:760-845-3887
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-12
Last Update Date:2014-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA50962106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist