Active NPI
Carole Goguen, PSY.D.
- Clinical Psychologist
- Altadena, CA
National Provider Identifier
1386753192
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY17685
- Practice address
- 2591 Fair Oaks Ave
#332
Altadena, CA 91001 - Phone
- (626) 765-1846
- NPI assigned
- Aug 29, 2006
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY17685 | CA | Primary |
Addresses
Primary practice location
2591 Fair Oaks Ave
#332
Altadena, CA 91001
Mailing address
2591 Fair Oaks Ave
#332
Altadena, CA 91001
Phone (626) 765-1846
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: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Nov 19, 2019 through Nov 19, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY17685 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156809600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620086400000",
"number": "1386753192",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2591 FAIR OAKS AVE",
"address_2": "#332",
"city": "ALTADENA",
"state": "CA",
"postal_code": "91001",
"telephone_number": "626-765-1846"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2591 FAIR OAKS AVE",
"address_2": "#332",
"city": "ALTADENA",
"state": "CA",
"postal_code": "91001",
"telephone_number": "626-765-1846"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOGUEN",
"first_name": "CAROLE",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-29",
"last_updated": "2021-05-04",
"certification_date": "2021-05-04",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY17685",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Altadena, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2021; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.