Individual
BLANCA GODINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
790 S STATE ST STE 6, SAN JACINTO, CA 92583-4924
(951) 654-6002
Mailing address
25765 ECHO VALLEY RD, HOMELAND, CA 92548-9619
(951) 293-9455
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
R1571920724
CA
1041C0700X
Clinical Social Worker
Primary
126624
—
Other
Enumeration date
02/01/2021
Last updated
02/27/2025
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