Individual provider Active NPI

Janice Groesbeck Goldfarb, PSY.D.

  • Clinical Psychologist
  • San Diego, CA
National Provider Identifier
1407097959
Registry record updated Mar 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY 22539 Issued in CA
Practice address
3576 3Rd Ave
San Diego, CA 92103-4909
Phone
(619) 294-9535
Fax
(619) 295-4113
NPI assigned
Mar 12, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 12, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY 22539 CA Primary

Addresses

Primary practice location

3576 3Rd Ave
San Diego, CA 92103-4909

Mailing address

3576 3Rd Ave
San Diego, CA 92103-4909
Phone (619) 294-9535

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

State licenses

LicenseStateTypeSpecialty
PSY 22539CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Dana Fillmore, Psy.D., a Professional Psychology Corporation Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1236816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236816000000",
    "number": "1407097959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3576 3RD AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921034909",
            "telephone_number": "619-294-9535",
            "fax_number": "619-295-4113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3576 3RD AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921034909",
            "telephone_number": "619-294-9535",
            "fax_number": "619-295-4113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROESBECK GOLDFARB",
        "first_name": "JANICE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-03-12",
        "last_updated": "2009-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 22539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2009; 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.