Healthcare Provider Details

I. General information

NPI: 1619665064
Provider Name (Legal Business Name): ROSAURA GARCIA GODINEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2023
Last Update Date: 05/23/2026
Certification Date: 05/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 W GABILAN ST
SALINAS CA
93901-2769
US

IV. Provider business mailing address

1953 MARLENE AVE
REDDING CA
96002-4847
US

V. Phone/Fax

Practice location:
  • Phone: 831-625-5160
  • Fax:
Mailing address:
  • Phone: 831-258-8521
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number157581
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: