Healthcare Provider Details

I. General information

NPI: 1770213530
Provider Name (Legal Business Name): ALEJANDRA GODINEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/14/2022
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 EDMONDS RD
REDWOOD CITY CA
94062-3813
US

IV. Provider business mailing address

240 EDMONDS RD
REDWOOD CITY CA
94062-3813
US

V. Phone/Fax

Practice location:
  • Phone: 650-209-1100
  • Fax:
Mailing address:
  • Phone: 650-209-1100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number708589
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: