Active NPI
Jeffrey Goodyear
- Clinical Social Worker
- Santa Cruz, CA
National Provider Identifier
1366831570
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 93620
- Practice address
- 1400 Emeline Ave
Santa Cruz, CA 95060-1976 - Phone
- (831) 459-0444
- NPI assigned
- Jan 12, 2015
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 93620 | CA | Primary |
Addresses
Primary practice location
1400 Emeline Ave
Santa Cruz, CA 95060-1976
Mailing address
1400 Emeline Ave
Santa Cruz, CA 95060-1976
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 93620 | CA | MD | Clinical Social Worker |
| 71512 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1421020800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1705449600000",
"number": "1366831570",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1400 EMELINE AVE",
"city": "SANTA CRUZ",
"state": "CA",
"postal_code": "950601976"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 EMELINE AVE",
"city": "SANTA CRUZ",
"state": "CA",
"postal_code": "950601976",
"telephone_number": "831-459-0444"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOODYEAR",
"first_name": "JEFFREY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-01-12",
"last_updated": "2024-01-17",
"certification_date": "2024-01-17",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "93620",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Cruz, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.