Individual provider Active NPI

Kathryn Deena Goodman, ARNP

  • Women's Health Clinical Nurse Specialist
  • North Hollywood, CA
National Provider Identifier
1013090398
Registry record updated Apr 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Clinical Nurse SpecialistTaxonomy code 364SW0102X
License
NP# 1691 Issued in CA
Practice address
6801 Coldwater Canyon Ave
Valley Community Clinic
North Hollywood, CA 91605
Phone
(818) 301-6320
Fax
(818) 766-8352
NPI assigned
Oct 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Clinical Nurse Specialist 364SW0102X RN # 312998 CA
Women's Health Clinical Nurse Specialist 364SW0102X NP# 1691 CA Primary

Addresses

Primary practice location

6801 Coldwater Canyon Ave
Valley Community Clinic
North Hollywood, CA 91605

Mailing address

1912 Topaz Ave
Ventura, CA 93004-3157
Phone (954) 536-7422

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
NP# 1691CAMDWomen's Health Clinical Nurse Specialist
RN # 312998CAMDWomen's Health Clinical Nurse Specialist

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334275200000",
    "number": "1013090398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1912 TOPAZ AVE",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930043157",
            "telephone_number": "954-536-7422",
            "fax_number": "805-323-5644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6801 COLDWATER CANYON AVE",
            "address_2": "VALLEY COMMUNITY CLINIC",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "91605",
            "telephone_number": "818-301-6320",
            "fax_number": "818-766-8352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODMAN",
        "first_name": "KATHRYN",
        "middle_name": "DEENA",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-23",
        "last_updated": "2012-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SW0102X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Women's Health",
            "state": "CA",
            "license": "RN #  312998",
            "primary": false
        },
        {
            "code": "364SW0102X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Women's Health",
            "state": "CA",
            "license": "NP# 1691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Hollywood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2012; 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.