Healthcare Provider Details

I. General information

NPI: 1518365832
Provider Name (Legal Business Name): MRS. MICHELLE GOOD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2014
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2435 MARCONI AVE
SACRAMENTO CA
95821-4807
US

IV. Provider business mailing address

670 PLACERVILLE DR STE 2
PLACERVILLE CA
95667-4200
US

V. Phone/Fax

Practice location:
  • Phone: 916-313-8420
  • Fax:
Mailing address:
  • Phone: 530-644-2412
  • Fax: 530-644-8563

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: