Kimberly Ruth Gordacan, D.C.

Primary specialty

Neurology ChiropractorTaxonomy code 111NN0400X

License

17362 Issued in CA

Practice address

2050 W Steele LN Ste A2
Santa Rosa, CA 95403-3402

Phone

(707) 571-0393

Fax

(707) 571-0320

NPI assigned

Jun 6, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1181088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1770786030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2050 W STEELE LN STE A2",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954033402",
            "telephone_number": "707-571-0393",
            "fax_number": "707-571-0320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2050 W STEELE LN STE A2",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954033402",
            "telephone_number": "707-571-0393",
            "fax_number": "707-571-0320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDACAN",
        "first_name": "KIMBERLY",
        "middle_name": "RUTH",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NN0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Neurology",
            "state": "CA",
            "license": "17362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Barbara Ann Goodridge, LCSW #5783
• Alex Goodwin
• Christina Marie Goodwin, M.D.
• Gala Patrice Goodwin, LCSW
• Aaron Gootzeit, DC
• Kristin Gordiejew, LMFT
• Stephen Gordinier
• Amanda Kate Gordon
• Eric David Gordon, M.D.
• Lily Katherine Gordon

• Neurology Chiropractor in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Neurology Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.