Provider Demographics
NPI:1942173067
Name:GODWIN, NDIDIAMAKA LEAH (CNA)
Entity type:Individual
Prefix:
First Name:NDIDIAMAKA
Middle Name:LEAH
Last Name:GODWIN
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9890 BURR ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94605-4802
Mailing Address - Country:US
Mailing Address - Phone:510-944-9900
Mailing Address - Fax:
Practice Address - Street 1:268 LEWELLING BLVD
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:CA
Practice Address - Zip Code:94580-1632
Practice Address - Country:US
Practice Address - Phone:916-628-0851
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-25
Last Update Date:2025-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health