Individual
JORDAN AUSTIN KAI GOUVEIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
EMT
Contact information
Practice address
1500 PETALUMA BLVD S, PETALUMA, CA 94952-5545
(707) 765-8488
Mailing address
1500 PETALUMA BLVD S, PETALUMA, CA 94952-5545
(707) 765-8488
Taxonomy
Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
E177413
CA
Other
Enumeration date
08/25/2025
Last updated
08/25/2025
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