| Doctor Name: | MS. MARCIA LYNN ST. GODDARD |
| NPI Number: | 1750660155 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | DPT, CSCS |
| License Number: | 2438 |
| Business Practice Address: | 1003 River St Santa Cruz, CA - 950601754 |
| Business Phone Number: | 8314751800 |
| Business Fax Number: | 8314751802 |
| Mailing Address: | 4205 San Felipe Road, Suite 100 SAN JOSE |
| State: | CA |
| Postal Code: | 951351546 |
| Phone Number: | 4082381552 |
| Fax Number: | |
| NPI Enumeration Date: | 08/16/2011 |
| NPI Last Update Date: | 09/11/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 2438 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MT |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |