Active NPI
Lorraine Goodwin, FNP
- Family Nurse Practitioner
- San Diego, CA
National Provider Identifier
1114077260
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 13171
- Practice address
- 4311 3Rd Ave
San Diego, CA 92103-1407 - Phone
- (619) 688-1600
- NPI assigned
- Jan 11, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 13171 | CA | Primary |
Addresses
Primary practice location
4311 3Rd Ave
San Diego, CA 92103-1407
Mailing address
4311 3Rd Ave
San Diego, CA 92103-1407
Phone (619) 688-1600
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| WNP595213A | Other | CA | PPIN |
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)
- Enrolled
- Credentials
- Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168473600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1114077260",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4311 3RD AVE",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921031407",
"telephone_number": "619-688-1600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4311 3RD AVE",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921031407",
"telephone_number": "619-688-1600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOODWIN",
"first_name": "LORRAINE",
"credential": "FNP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CA",
"license": "13171",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PPIN",
"identifier": "WNP595213A",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.