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General NPI Number Information
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NPI Number | 1093436396
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Entity Type | Individual
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Provider Name | AMBER RAE GODWIN AMFT
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Gender | Female
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Dates
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Enumeration Date | 09/06/2022
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Last Update Date | 10/16/2025
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Provider Practice Location Address
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Address Line | 828 SAN PABLO AVE STE 120C
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City | ALBANY
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State | CA
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Zip | 94706-1694
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Country | US
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Telephone | 510-905-8737
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Fax |
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Provider Business Mailing Address
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Address Line | 828 SAN PABLO AVE STE 120C
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City | ALBANY
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State | CA
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Zip | 94706-1694
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Country | US
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Telephone | 510-905-8737
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 144905
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License Number State | CA
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