Active NPI
Stephen Norman Goldman, MA CCC
- Speech-Language Pathologist
- San Diego, CA
National Provider Identifier
1497032494
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SP4743
- Practice address
- 200 W Arbor Dr # 8775
San Diego, CA 92103-1911 - Phone
- (619) 543-6530
- Fax
- (619) 543-7808
- NPI assigned
- Nov 4, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SP4743 | CA | Primary |
Addresses
Primary practice location
200 W Arbor Dr # 8775
San Diego, CA 92103-1911
Mailing address
200 West Arbor Drive Mailcode 8775
San Diego, CA 92103
Phone (619) 543-6530
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SP4743 | CA | MD | Speech-Language Pathologist |
| 4743 | CA | MD | Clinical Nurse Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1320364800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1320364800000",
"number": "1497032494",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 WEST ARBOR DRIVE MAILCODE 8775",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "92103",
"telephone_number": "619-543-6530",
"fax_number": "619-543-7808"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 W ARBOR DR # 8775",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921031911",
"telephone_number": "619-543-6530",
"fax_number": "619-543-7808"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDMAN",
"first_name": "STEPHEN",
"middle_name": "NORMAN",
"name_prefix": "Mr.",
"credential": "MA CCC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-11-04",
"last_updated": "2011-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "CA",
"license": "SP4743",
"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 Nov 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.