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General NPI Number Information
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NPI Number | 1144801697
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Entity Type | Individual
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Provider Name | SANDRA C GOLDBERG ND, LAC
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Gender | Female
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Dates
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Enumeration Date | 04/16/2021
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Last Update Date | 04/16/2021
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Provider Practice Location Address
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Address Line | 12900 WOOLMAN LN
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City | NEVADA CITY
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State | CA
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Zip | 95959-9700
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Country | US
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Telephone | 503-956-1502
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Fax |
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Provider Business Mailing Address
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Address Line | 1051 NE 6TH ST # 422
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City | GRANTS PASS
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State | OR
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Zip | 97526-1190
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Country | US
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Telephone | 503-956-1502
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 380
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License Number State | CA
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