Provider Demographics
NPI:1629213277
Name:GODINEZ, JENNIFER
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
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 1:3804 VALLEY VISTA AVE
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-6519
Mailing Address - Country:US
Mailing Address - Phone:661-889-5722
Mailing Address - Fax:
Practice Address - Street 1:1001 TOWER WAY
Practice Address - Street 2:SUITE 250
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-1597
Practice Address - Country:US
Practice Address - Phone:661-323-1233
Practice Address - Fax:661-323-8090
Is Sole Proprietor?:No
Enumeration Date:2008-12-11
Last Update Date:2014-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator