Individual provider Active NPI

Shirley Ann Gooch, R.N., PH.D.

  • Registered Nurse
  • Beverly Hills, CA
National Provider Identifier
1396860904
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
W117634 Issued in CA
Practice address
433 N Camden Dr
Suite 1108
Beverly Hills, CA 90210-4409
Phone
(310) 281-8981
Fax
(310) 556-3714
NPI assigned
Mar 20, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent Psychologist 103TC2200X PSY9767 CA
Registered Nurse 163W00000X W117634 CA Primary

Addresses

Primary practice location

433 N Camden Dr
Suite 1108
Beverly Hills, CA 90210-4409

Mailing address

308 S Rodeo Dr
Beverly Hills, CA 90212-4207
Phone (310) 281-8981

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 Philosophy, Registered Nurse

State licenses

LicenseStateTypeSpecialty
PSY9767CAMDClinical Child & Adolescent Psychologist
W117634CAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1396860904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 S RODEO DR",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902124207",
            "telephone_number": "310-281-8981",
            "fax_number": "310-556-3714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "433 N CAMDEN DR",
            "address_2": "SUITE 1108",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902104409",
            "telephone_number": "310-281-8981",
            "fax_number": "310-556-3714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOOCH",
        "first_name": "SHIRLEY",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "R.N., PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-20",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "CA",
            "license": "PSY9767",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "W117634",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.