Individual provider Active NPI

Christina Goodall

  • Marriage & Family Therapist
  • San Diego, CA
National Provider Identifier
1609315811
Registry record updated Apr 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT124197 Issued in CA
Practice address
17140 Bernardo Center Dr Ste 225
San Diego, CA 92128-2088
Phone
(833) 579-4848
NPI assigned
Feb 21, 2017
Last updated
Apr 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 4, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Marriage & Family Therapist 106H00000X 124197 CA
Marriage & Family Therapist 106H00000X LMFT124197 CA Primary

Addresses

Primary practice location

17140 Bernardo Center Dr Ste 225
San Diego, CA 92128-2088

Mailing address

17140 Bernardo Center Dr Ste 225
San Diego, CA 92128-2088
Phone (833) 579-4848

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240710004675 CA Practitioner - Marriage and Family Therapist 7517402894 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
124197CAMDClinical Social Worker
LMFT124197CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince May 26, 2024 Accepting new patients
Southern California Permanente Medical Group CurrentSince May 26, 2024 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Community Research Foundation Inc Past Accepting new patients
Community Research Foundation Inc Past Accepting new patients

Locations

393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914

17140 Bernardo Center Dr
San Diego, CA 92128
Phone (858) 451-5033

17140 Bernardo Center Dr
Ste 225
San Diego, CA 92128
Phone (877) 496-0450

4647 Zion Ave
San Diego, CA 92120
Phone (619) 528-3038

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1487635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712188800000",
    "number": "1609315811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17140 BERNARDO CENTER DR STE 225",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921282088",
            "telephone_number": "833-579-4848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17140 BERNARDO CENTER DR STE 225",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921282088",
            "telephone_number": "833-579-4848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODALL",
        "first_name": "CHRISTINA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-21",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "124197",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT124197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.