Jerry M Goffman, PHD.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY7081 Issued in CA

Practice address

8253 White Oak Ave
Rancho Cucamonga, CA 91730-7671

Phone

(951) 312-1041

NPI assigned

Aug 29, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Calcare Hospice, Inc.

  • Community Based Hospice Care Agency
  • Rancho Cucamonga, CA
  • NPI 1518339548
  NPD (past)

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191196800000",
    "number": "1124137765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 S MOUNT VERNON AVE",
            "address_2": "G-306",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923244228",
            "telephone_number": "951-312-1041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8253 WHITE OAK AVE",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917307671",
            "telephone_number": "951-312-1041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOFFMAN",
        "first_name": "JERRY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PHD.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2007-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY7081",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PSY070812",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PSY070811",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Girls Gossip and Women Network LLC (N/a)
• Allyssa Giron, RBT
• Leslie Nicole Gledhill
• Matthew C Glidden, PSYD
• Globalgslogistics LLC
• Gogo Medical Transport Inc.
• Abraham Ian Gold
• Golden Home Health Provider, Inc
• Golden One Hospice, Inc.
• Golden Touch Hospice Care,Inc.

• Psychologist in Rancho Cucamonga, CA
• Providers in Rancho Cucamonga, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 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.

Verify at the official NPI Registry.