Pamela Deloris Davis Goodacre, LVN

Primary specialty

Licensed Vocational NurseTaxonomy code 164X00000X

License

151365 Issued in CA

Practice address

4450 W Century Blvd
Inglewood, CA 90304-1504

Phone

(310) 671-0555

NPI assigned

Jun 9, 2021

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

Electronic endpoints 1

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": "1623196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623196800000",
    "number": "1104493055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 E TAMARACK AVE APT 7",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903012759",
            "telephone_number": "661-992-2956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4450 W CENTURY BLVD",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903041504",
            "telephone_number": "310-671-0555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS GOODACRE",
        "first_name": "PAMELA",
        "middle_name": "DELORIS",
        "credential": "LVN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-09",
        "last_updated": "2021-06-09",
        "certification_date": "2021-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "151365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "email",
            "affiliation": "N",
            "address_1": "4450 W Century Blvd",
            "city": "Inglewood",
            "state": "CA",
            "country_code": "US",
            "postal_code": "903041504",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Das Care, Inc.
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• Yalda Serena Dastmalchi, MD
• Bruce Charles Daugherty, MD
• Danielle L Davidson-McBean
• Bree Elizabeth Davis, PSY.D.
• Debra Ann Davis
• Delores Davis
• Duane Davis
• Harry James Davis, ADDICTION THERAPIST

• Licensed Vocational Nurse in Inglewood, CA
• Providers in Inglewood, CA by specialty
• Licensed Vocational Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2021; 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.