Active NPI
Jenna Rae Goodson
- Case Manager/Care Coordinator
- Sacramento, CA
National Provider Identifier
1164951091
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- Practice address
- 900 Fulton Ave
Sacramento, CA 95825 - Phone
- (916) 484-3570
- NPI assigned
- Jun 5, 2017
- Last updated
- Jun 5, 2017
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | NU | Primary |
Addresses
Primary practice location
900 Fulton Ave
Sacramento, CA 95825
Mailing address
4209 Rolling Hills Lane
Vacaville, CA 95688
Phone (707) 592-7303
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1496620800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1496620800000",
"number": "1164951091",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4209 ROLLING HILLS LANE",
"city": "VACAVILLE",
"state": "CA",
"postal_code": "95688",
"telephone_number": "707-592-7303"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 FULTON AVE",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "95825",
"telephone_number": "916-484-3570"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOODSON",
"first_name": "JENNA",
"middle_name": "RAE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-06-05",
"last_updated": "2017-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.