Individual provider Active NPI

Gabriele Goodman

  • Health Psychologist
  • Walnut Creek, CA
National Provider Identifier
1457878803
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health PsychologistTaxonomy code 103TH0004X
License
PSY29188 Issued in CA
Practice address
43 Quail CT Ste 111
Walnut Creek, CA 94596-5546
Phone
(925) 954-1618
NPI assigned
Aug 26, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Psychologist 103TH0004X PSY29188 CA Primary

Addresses

Primary practice location

43 Quail CT Ste 111
Walnut Creek, CA 94596-5546

Mailing address

34 Chimney Rock
Oakland, CA 94605-4605
Phone (510) 967-3776

Other practice location 1

445 Bellevue Ave Ste 201
Oakland, CA 94610-4923
Phone (510) 967-3776

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

State licenses

LicenseStateTypeSpecialty
PSY29188CAMDHealth Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1503705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1457878803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 CHIMNEY ROCK",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946054605",
            "telephone_number": "510-967-3776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43 QUAIL CT STE 111",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945965546",
            "telephone_number": "925-954-1618"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "445 Bellevue Ave Ste 201",
            "address_purpose": "LOCATION",
            "city": "Oakland",
            "state": "CA",
            "postal_code": "946104923",
            "country_code": "US",
            "telephone_number": "510-967-3776",
            "fax_number": "510-967-3776",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOODMAN",
        "first_name": "GABRIELE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-26",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TH0004X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health",
            "state": "CA",
            "license": "PSY29188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walnut Creek, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.