Amy Melissa Goodson

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

144059 Issued in CA

Practice address

1336 Bridgegate Dr
Diamond Bar, CA 91765-3955

Phone

(626) 851-1011

NPI assigned

Apr 8, 2024

Last updated

Nov 7, 2024By the provider in NPPES

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1712534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730937600000",
    "number": "1003669250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4026 N NORA AVE",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917223820",
            "telephone_number": "626-678-3130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1336 BRIDGEGATE DR",
            "city": "DIAMOND BAR",
            "state": "CA",
            "postal_code": "917653955",
            "telephone_number": "626-851-1011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODSON",
        "first_name": "AMY",
        "middle_name": "MELISSA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-08",
        "last_updated": "2024-11-07",
        "certification_date": "2024-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "144059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Marriage & Family Therapist in Diamond Bar, CA
• Providers in Diamond Bar, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2024; 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.