Individual
HEIDI MAY GODDARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1555 SOQUEL DR, SANTA CRUZ, CA 95065
(831) 462-7700
Mailing address
415 14TH AVE, SANTA CRUZ, CA 95062-4821
(503) 312-0589
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
A159958
CA
207P00000X
Emergency Medicine Physician
AM1090896-08
ME
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/14/2013
Last updated
07/02/2019
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