Provider Demographics
NPI:1730228834
Name:GOYHENETCHE, NADINE (CPRP)
Entity type:Individual
Prefix:
First Name:NADINE
Middle Name:
Last Name:GOYHENETCHE
Suffix:
Gender:F
Credentials:CPRP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2419 21ST AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94116-2409
Mailing Address - Country:US
Mailing Address - Phone:415-681-4244
Mailing Address - Fax:
Practice Address - Street 1:2 EDGEWOOD CT
Practice Address - Street 2:
Practice Address - City:DALY CITY
Practice Address - State:CA
Practice Address - Zip Code:94014-1841
Practice Address - Country:US
Practice Address - Phone:650-994-7110
Practice Address - Fax:650-994-7180
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselor
Not Answered225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA170771OtherCPRP