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DON M GOODMAN INC.

Health

Thousand Oaks, California

Provider NPI: 1023342805

Organization Information:
Organization Name:  DON M GOODMAN INC.
Organization is not Subpart
Authorized Official:  DONALD MITCHELL GOODMAN  CLINICAL PSYCHOLOGIST  818-9174524

Practice Location:
101 HODENCAMP RD SUITE 114 THOUSAND OAKS, CA 91360 US
Tel: 818-917-4524  Fax: 805-449-2942

Business Mailing Address:
101 HODENCAMP RD SUITE 114 THOUSAND OAKS, CA 91360 US
Tel: 818-917-4524  Fax: 805-449-2942

Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N103TH0004XBehavioral Health & Social Service Providers
Psychologist
Health
CAPSY 22613
N103TP2701XBehavioral Health & Social Service Providers
Psychologist
CAPSY 22613
N103TB0200XBehavioral Health & Social Service Providers
Psychologist
CAPSY 22613
Y103TC0700XBehavioral Health & Social Service Providers
Psychologist
CAPSY 22613

Other Provider Identifiers:

IssuerNumberStateType
NPI1871724518CA01
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







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