Individual
TABITHA GOODMAN-CORDERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
438 N WHITE RD, SAN JOSE, CA 95127-1439
(408) 510-6284
(408) 642-6052
Mailing address
1922 THE ALAMEDA STE 316, SAN JOSE, CA 95126-1461
(408) 261-7777
(408) 642-6052
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
MPSS-HADQEZ
CA
390200000X
Student in an Organized Health Care Education/Training Program
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—
Other
Enumeration date
09/05/2024
Last updated
05/29/2025
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