Individual
ANDREA PATRICIA GODINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9916 CENTRAL AVE, MONTCLAIR, CA 91763-3201
(909) 450-2502
Mailing address
9916 CENTRAL AVE, MONTCLAIR, CA 91763-3201
(909) 450-2502
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/09/2019
Last updated
07/09/2019
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