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General NPI Number Information
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NPI Number | 1518877893
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Entity Type | Individual
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Provider Name | HECTOR MANUEL GODINEZ JR.
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Gender | Male
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Dates
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Enumeration Date | 09/09/2026
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Last Update Date | 09/09/2026
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Provider Practice Location Address
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Address Line | 1160 N DUTTON AVE STE 120
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City | SANTA ROSA
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State | CA
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Zip | 95401-4652
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Country | US
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Telephone | 707-541-6258
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Fax |
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Provider Business Mailing Address
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Address Line | 1205 MYRTLE ST APT 7
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City | CALISTOGA
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State | CA
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Zip | 94515-1753
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Country | US
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Telephone | 510-365-4286
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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 | 172M00000X
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Taxonomy Name | Mechanotherapist
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License Number | 94591
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License Number State | CA
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