Healthcare Provider Details

I. General information

NPI: 1083336218
Provider Name (Legal Business Name): SARA GOODRICH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2022
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

539 G ST STE 210
EUREKA CA
95501-1030
US

IV. Provider business mailing address

3163 HALFWAY AVE
MCKINLEYVILLE CA
95519-9330
US

V. Phone/Fax

Practice location:
  • Phone: 707-273-4846
  • Fax:
Mailing address:
  • Phone: 734-216-1106
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number142701
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: