Active NPI
Andrea Renee Goldstein, NP
- Adult Health Nurse Practitioner
- Pasadena, CA
National Provider Identifier
1306133418
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- 17659
- Practice address
- 660 S Fair Oaks Ave
Pasadena, CA 91105-2616 - Phone
- (626) 397-5820
- Fax
- (626) 397-5827
- NPI assigned
- Jul 9, 2011
- 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 |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 17659 | CA | Primary |
Addresses
Primary practice location
660 S Fair Oaks Ave
Pasadena, CA 91105-2616
Mailing address
11525 Ohio Ave Apt 5
Los Angeles, CA 90025-3017
Phone (310) 479-3975
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
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17659 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1310169600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1310169600000",
"number": "1306133418",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11525 OHIO AVE APT 5",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900253017",
"telephone_number": "310-479-3975",
"fax_number": "310-966-9023"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "660 S FAIR OAKS AVE",
"city": "PASADENA",
"state": "CA",
"postal_code": "911052616",
"telephone_number": "626-397-5820",
"fax_number": "626-397-5827"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDSTEIN",
"first_name": "ANDREA",
"middle_name": "RENEE",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-07-09",
"last_updated": "2011-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "CA",
"license": "17659",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pasadena, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.