Active NPI
Paula Jensen Goodfellow, CCC-SLP, MA
- Speech-Language Pathologist
- Encinitas, CA
National Provider Identifier
1477288629
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 20791
- Practice address
- 1849 Avenida Mimosa
Encinitas, CA 92024-7121 - Phone
- (760) 845-6678
- NPI assigned
- Jul 21, 2022
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Assistant | 2355S0801X | 12121212 | CA | |
| Speech-Language Pathologist | 235Z00000X | 20791 | CA | Primary |
Addresses
Primary practice location
1849 Avenida Mimosa
Encinitas, CA 92024-7121
Mailing address
1849 Avenida Mimosa
Encinitas, CA 92024-7121
Phone (760) 845-6678
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
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20791 | CA | MD | Addiction (Substance Use Disorder) Counselor |
| 12121212 | CA | MD | Speech-Language Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1658361600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1477288629",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1849 AVENIDA MIMOSA",
"city": "ENCINITAS",
"state": "CA",
"postal_code": "920247121",
"telephone_number": "760-845-6678"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1849 AVENIDA MIMOSA",
"city": "ENCINITAS",
"state": "CA",
"postal_code": "920247121",
"telephone_number": "760-845-6678"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOODFELLOW",
"first_name": "PAULA",
"middle_name": "JENSEN",
"credential": "CCC-SLP, MA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-07-21",
"last_updated": "2022-07-21",
"certification_date": "2022-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "2355S0801X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Speech-Language Assistant",
"state": "CA",
"license": "12121212",
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "CA",
"license": "20791",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Encinitas, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.