Jessica V Goodman

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

101361 Issued in CA

Practice address

1918 Bonita Ave Ste 200
Berkeley, CA 94704-1014

Phone

(707) 435-3764

NPI assigned

Dec 7, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1481068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665964800000",
    "number": "1487198651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1918 BONITA AVE STE 200",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947041014",
            "telephone_number": "707-435-3764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1918 BONITA AVE STE 200",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947041014",
            "telephone_number": "707-435-3764"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10221 Compton Ave",
            "address_2": "Suite 104 & 203",
            "address_purpose": "LOCATION",
            "city": "Watts",
            "state": "CA",
            "postal_code": "900022802",
            "country_code": "US",
            "telephone_number": "213-385-5100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOODMAN",
        "first_name": "JESSICA",
        "middle_name": "V",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-12-07",
        "last_updated": "2022-10-17",
        "certification_date": "2022-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "69425",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "101361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victoria Crystelle Gonzalez
• Vivian Carter Goo, P.T,
• Emma Goodfield
• Eva L. Goodfriend-Reano, CNM
• Lindsay Erin Goodlin, MSW
• Karole Goodman
• Matthew Reader Goodman, PH.D.
• Jonathan Goodrich
• Benjamin Ashby Goodrum, CNM, FNP
• Karen M Goodwin, D.O.

• Clinical Social Worker in Berkeley, CA
• Providers in Berkeley, CA by specialty
• Clinical Social Worker in California

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

Verify at the official NPI Registry.