Healthcare Provider Details

I. General information

NPI: 1366328429
Provider Name (Legal Business Name): OLIVIA RIO GODBY CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 SUTTER PL STE 230
DAVIS CA
95616-6213
US

IV. Provider business mailing address

PO BOX 255228
SACRAMENTO CA
95865-5228
US

V. Phone/Fax

Practice location:
  • Phone: 530-750-5880
  • Fax: 530-750-5881
Mailing address:
  • Phone: 800-470-0071
  • Fax: 916-854-6769

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number236560
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: