Individual provider Active NPI

Judy Goldstein, M.D.

  • Pediatric Neurodevelopmental Disabilities Physician
  • San Diego, CA
National Provider Identifier
1295811990
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Neurodevelopmental Disabilities PhysicianTaxonomy code 2080P0008X
License
G17671 Issued in CA
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

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
G17671CAMDPediatric 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.

Verify at the official NPI Registry.