Provider Demographics
NPI:1447956438
Name:MCGOLDRICK, HEATHER MARILYN (ATC)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:MARILYN
Last Name:MCGOLDRICK
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5025 BRADFORD DR
Mailing Address - Street 2:
Mailing Address - City:ROCKLIN
Mailing Address - State:CA
Mailing Address - Zip Code:95765-5325
Mailing Address - Country:US
Mailing Address - Phone:916-622-3443
Mailing Address - Fax:
Practice Address - Street 1:2949 PORTAGE BAY W APT 159
Practice Address - Street 2:
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95616-2871
Practice Address - Country:US
Practice Address - Phone:916-622-3443
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-01
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer