Jessica Diane Goldberg

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

A76156 Issued in CA

Practice address

2640 Industry Way
Lynwood, CA 90262-4284

Phone

(310) 627-4525

NPI assigned

Sep 16, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Mental Health America of Los Angeles

  • Community/Behavioral Health Agency
  • Long Beach, CA
  • NPI 1326164245
  NPD
• Mental Health America of Los Angeles

  • Community/Behavioral Health Agency
  • Long Beach, CA
  • NPI 1386760213
  NPD

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

{
    "created_epoch": "1253059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674172800000",
    "number": "1194058545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2640 INDUSTRY WAY",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902624284",
            "telephone_number": "310-627-4525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2640 INDUSTRY WAY",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902624284",
            "telephone_number": "310-627-4525"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1955 Long Beach Blvd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Long Beach",
            "state": "CA",
            "postal_code": "908065501",
            "country_code": "US",
            "telephone_number": "562-437-6717",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOLDBERG",
        "first_name": "JESSICA",
        "middle_name": "DIANE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-16",
        "last_updated": "2023-01-20",
        "certification_date": "2023-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "A76156",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jane Lee Gin, M.D.
• Nijole Glaze, M.D.
• Martha Tinehyn Glomah
• Glory Care Residential LLC
• Aurora Godinez
• Adam Golden
• Dawn R Goldstein, MD
• Jenna Eden Goldstein, MSW
• Qiseana A Gomes
• Ana Karen Gomez

• Mental Health Counselor in Lynwood, CA
• Providers in Lynwood, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2023; 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.