Provider Demographics
NPI:1568215564
Name:GODINEZ, CATHERINE MADELAINE
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:MADELAINE
Last Name:GODINEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10232 WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90241-2407
Mailing Address - Country:US
Mailing Address - Phone:562-472-6918
Mailing Address - Fax:
Practice Address - Street 1:5400 E OLYMPIC BLVD STE 225
Practice Address - Street 2:
Practice Address - City:COMMERCE
Practice Address - State:CA
Practice Address - Zip Code:90022-5154
Practice Address - Country:US
Practice Address - Phone:213-226-0969
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-09
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)