Travis Goodman, M.S., LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

96857 Issued in CA

Practice address

4060 Campus Dr
Suite #110
Newport Beach, CA 92660-2217

Phone

(949) 282-4764

NPI assigned

Jan 30, 2014

Last updated

Nov 18, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

Practice roles

Locations

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

• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Baldwin Park, CA
  • NPI 1770515280
  Medicare reassignment NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Santa Clarita, CA
  • NPI 1316409410
  NPD
• Southern California Permanente Medical Group

  dba Target Clinic Medical Associates of Southern California

  • Health Maintenance Organization
  • Fullerton, CA
  • NPI 1336556059
  NPD

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

{
    "created_epoch": "1391040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479427200000",
    "number": "1417370255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4060 CAMPUS DR",
            "address_2": "SUITE #110",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926602217",
            "telephone_number": "949-282-4764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4060 CAMPUS DR",
            "address_2": "SUITE #110",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926602217",
            "telephone_number": "949-282-4764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODMAN",
        "first_name": "TRAVIS",
        "credential": "M.S., LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-01-30",
        "last_updated": "2016-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "96857",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BBS",
            "identifier": "96857",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Good Shepherd Medical Center
• Julie Ann Goode, LMFT
• Shanna Lillian Goode, MFT
• Danielle Goodman, DDS
• Gilbert Goodman, M.D.
• Jake Gooing, DO
• Basil Gordon, D.D.S.
• Danielle Gordon, PT, DPT
• Ellen Gordon, MA, MFT
• Laura Gordon

• Marriage & Family Therapist in Newport Beach, CA
• Providers in Newport Beach, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2016; 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.

Verify at the official NPI Registry.