Individual
MS. JEAN ANNETTE GOFORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
4700 ELVAS AVE, SACRAMENTO, CA 95819-2250
(916) 454-4700
Mailing address
6177 GREENHAVEN DR APT A, SACRAMENTO, CA 95831-1652
(530) 329-6854
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA 1509
CA
Other
Enumeration date
03/14/2007
Last updated
07/08/2007
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