Active NPI
Judy Goldstein, M.D.
- Pediatric Neurodevelopmental Disabilities Physician
- San Diego, CA
National Provider Identifier
1295811990
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Neurodevelopmental Disabilities Physician
- License
- G17671
- Practice address
- 4355 Ruffin Rd
San Diego, CA 92123-4306 - Phone
- (858) 576-2957
- NPI assigned
- Oct 27, 2006
- 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 |
|---|---|---|---|---|
| Pediatric Neurodevelopmental Disabilities Physician | 2080P0008X | G17671 | CA | Primary |
Addresses
Primary practice location
4355 Ruffin Rd
San Diego, CA 92123-4306
Mailing address
1166 Sierra Linda Dr
Escondido, CA 92025-7642
Phone (858) 576-2957
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G17671 | CA | MD | Pediatric Neurodevelopmental Disabilities Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161907200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1295811990",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1166 SIERRA LINDA DR",
"city": "ESCONDIDO",
"state": "CA",
"postal_code": "920257642",
"telephone_number": "858-576-2957"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4355 RUFFIN RD",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921234306",
"telephone_number": "858-576-2957"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDSTEIN",
"first_name": "JUDY",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2080P0008X",
"taxonomy_group": "",
"desc": "Pediatrics, Neurodevelopmental Disabilities",
"state": "CA",
"license": "G17671",
"primary": true
}
],
"identifiers": [],
"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.