Individual provider Active NPI

Marilyn J Goetz de Gaona, NP

  • Women's Health Nurse Practitioner
  • Santa Barbara, CA
National Provider Identifier
1336218759
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
NP1415 Issued in CA
Practice address
1900 State St
Suite G
Santa Barbara, CA 93101-2429
Phone
(805) 617-7858
Fax
(805) 898-2002
NPI assigned
Nov 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X NP1415 CA Primary

Addresses

Primary practice location

1900 State St
Suite G
Santa Barbara, CA 93101-2429

Mailing address

1900 State St
Suite G
Santa Barbara, CA 93101-2429
Phone (805) 617-7858

Other identifiers 1

IdentifierTypeStateIssuer
NP1415OtherCANURSE PRACTITIONER LICENS

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1415CAMDProfessional Counselor
NP1415CAMDWomen's Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1336218759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 STATE ST",
            "address_2": "SUITE G",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931012429",
            "telephone_number": "805-617-7858",
            "fax_number": "805-898-2002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 STATE ST",
            "address_2": "SUITE G",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931012429",
            "telephone_number": "805-617-7858",
            "fax_number": "805-898-2002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOETZ DE GAONA",
        "first_name": "MARILYN",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-07",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "CA",
            "license": "NP1415",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE PRACTITIONER LICENS",
            "identifier": "NP1415",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Barbara, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.