Stacey A Goodman Eaton, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCS18913 Issued in CA

Practice address

12520 High Bluff Dr
Ste 135
San Diego, CA 92130-3066

Phone

(619) 383-6700

Fax

(619) 383-6701

NPI assigned

Jun 9, 2006

Last updated

Feb 16, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Stacey A Goodman Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Psychiatric Centers at San Diego, Inc. Med GRP

  • Mental Health Counselor
  • San Diego, CA
  • NPI 1841241585

  Clinical

  NPD (past)

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455580800000",
    "number": "1518908680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12520 HIGH BLUFF DR",
            "address_2": "STE 135",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921303066",
            "telephone_number": "619-528-4600",
            "fax_number": "619-528-4625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12520 HIGH BLUFF DR",
            "address_2": "STE 135",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921303066",
            "telephone_number": "619-383-6700",
            "fax_number": "619-383-6701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODMAN EATON",
        "first_name": "STACEY",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-09",
        "last_updated": "2016-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS18913",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACEY",
            "last_name": "GOODMAN",
            "middle_name": "A",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Carly Goodkin
• Mindy Goodlett, PHYSICIAN ASSISTANT
• Xavier Goodloe
• Glenn Putnam Goodlove, LCSW
• Gale Kirk Goodlow II, M.D.
• Skye Goodman-Janow
• Ashley Allen Goodman, DDS
• Brock Aaron Goodman, D.D.S.
• Eric Todd Goodman, M.D.
• Ira Lee Goodman, MD

• Clinical Social Worker in San Diego, CA
• Providers in San Diego, 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 Feb 16, 2016; 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.