Individual
MRS. KAYLA SIMONE GOODEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7418 BRAERIDGE WAY, SACRAMENTO, CA 95831-4004
(916) 402-6211
Mailing address
7418 BRAERIDGE WAY, SACRAMENTO, CA 95831-4004
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1437798188
NEMT
CA
Enumeration date
12/28/2019
Last updated
01/12/2020
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