Katherine Ryan Goetzke, CFNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

22591 Issued in CA

Practice address

340 Eureka SQ
Pacifica, CA 94044-2652

Phone

(650) 453-3467

NPI assigned

Jul 24, 2014

Sex

Female

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 24, 2014.

{
    "created_epoch": "1406160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406160000000",
    "number": "1538577366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 EUREKA SQ",
            "city": "PACIFICA",
            "state": "CA",
            "postal_code": "940442652",
            "telephone_number": "650-453-3467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 EUREKA SQ",
            "city": "PACIFICA",
            "state": "CA",
            "postal_code": "940442652",
            "telephone_number": "650-453-3467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOETZKE",
        "first_name": "KATHERINE",
        "middle_name": "RYAN",
        "credential": "CFNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-24",
        "last_updated": "2014-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CA",
            "license": "22591",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN",
            "identifier": "645705",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NP NUMBER",
            "identifier": "22591",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lynn Gallo, MFT
• Jennifer Lynne Gilman, MFT
• Priscilla Mary Gilmore, C.A.T.C.
• Maria Cardenas Gines, M.S., MFTI, PPSC
• Robin Elizabeth Gluck, MS, MFTI
• Charmaine Green
• Ellie Grubb
• Jesse Alexander Guzman, A.S.W
• Bianca Haas
• Sharon J Hagen, LCSW

• All providers in Pacifica, CA
• Pediatric Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2014; 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.