Angie Godchaux-Kelly
Day Training/Habilitation Specialist in Santa Rosa, CA. Individual provider (NPI-1).
NPI number1891663779
StatusActive
Last updated in NPPESNov 11, 2025
Details
- NPI
- 1891663779
- Entity type
- Individual (NPI-1)
- Name
- Angie Godchaux-Kelly
- Sole proprietor
- No
- Enumeration date
- Oct 23, 2025
- Certification date
- Nov 11, 2025
- Last updated
- Nov 11, 2025
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 373H00000X | Day Training/Habilitation Specialist | – | CA | Yes |
Practice location
3400 Montgomery DrSanta Rosa, CA 95405-5142
Phone 707-526-6902
Mailing address
3400 Montgomery DrSanta Rosa, CA 95405-5142
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 213 Day Training/Habilitation Specialist providers in Santa Rosa · All 8,142 providers in Santa Rosa
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