Provider Demographics
NPI:1023269404
Name:GODWIN, SUNSHINE S (MA COUNSELING PSYCH)
Entity type:Individual
Prefix:
First Name:SUNSHINE
Middle Name:S
Last Name:GODWIN
Suffix:
Gender:F
Credentials:MA COUNSELING PSYCH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45270 SUNBROOK LN
Mailing Address - Street 2:
Mailing Address - City:LA QUINTA
Mailing Address - State:CA
Mailing Address - Zip Code:92253-4117
Mailing Address - Country:US
Mailing Address - Phone:866-545-6295
Mailing Address - Fax:
Practice Address - Street 1:THE KILOBY CENTER FOR RECOVERY
Practice Address - Street 2:71-777 SAN JACINTO DRIVE
Practice Address - City:RANCHO MIRAGE
Practice Address - State:CA
Practice Address - Zip Code:92270
Practice Address - Country:US
Practice Address - Phone:866-545-6295
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-03
Last Update Date:2019-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA43900106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist