Active NPI
Melissa Nicole-Fisher Goldman, LCSW
- Clinical Social Worker
- Fullerton, CA
National Provider Identifier
1235516634
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LSW 26077
- Practice address
- 305 N Harbor Blvd Ste 202
Fullerton, CA 92832-1901 - Phone
- (714) 584-8072
- NPI assigned
- May 5, 2015
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LSW 26077 | CA | Primary |
Addresses
Primary practice location
305 N Harbor Blvd Ste 202
Fullerton, CA 92832-1901
Mailing address
305 N Harbor Blvd Ste 202
Fullerton, CA 92832-1901
Phone (714) 584-8072
Other names 1
- Melissa Fisher Goldman
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Nov 7, 2021 through Nov 7, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LSW 26077 | CA | MD | Clinical Social Worker |
| 26077 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1430784000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1430784000000",
"number": "1235516634",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "305 N HARBOR BLVD STE 202",
"city": "FULLERTON",
"state": "CA",
"postal_code": "928321901",
"telephone_number": "714-584-8072"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "305 N HARBOR BLVD STE 202",
"city": "FULLERTON",
"state": "CA",
"postal_code": "928321901",
"telephone_number": "714-584-8072"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDMAN",
"first_name": "MELISSA",
"middle_name": "NICOLE-FISHER",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-05-05",
"last_updated": "2015-05-05",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LSW 26077",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MELISSA",
"last_name": "FISHER GOLDMAN",
"credential": "LCSW",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Fullerton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.