Individual provider Active NPI

James Walter Goethel, M.A., LMFT

  • Marriage & Family Therapist
  • San Diego, CA
National Provider Identifier
1659888410
Registry record updated Jan 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Practice address
2535 Camino del Rio S Ste 106
San Diego, CA 92108-3764
Phone
(619) 330-6003
Fax
(619) 564-6666
NPI assigned
Jan 2, 2018
Last updated
Jan 2, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 2, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X Primary

Addresses

Primary practice location

2535 Camino del Rio S Ste 106
San Diego, CA 92108-3764

Mailing address

4862 54TH St
San Diego, CA 92115-2223
Phone (619) 892-5207

Other names 1

  • Jim Goethel Goethel Other name

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
I20240627004190 CA Practitioner - Marriage and Family Therapist 5294279550 Practice locations: San Diego, CA

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

San Diego, CA 92115
Phone (619) 892-5207

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

NPI Registry JSON

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

{
    "created_epoch": "1514851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514851200000",
    "number": "1659888410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4862 54TH ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921152223",
            "telephone_number": "619-892-5207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2535 CAMINO DEL RIO S STE 106",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083764",
            "telephone_number": "619-330-6003",
            "fax_number": "619-564-6666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOETHEL",
        "first_name": "JAMES",
        "middle_name": "WALTER",
        "name_prefix": "Mr.",
        "credential": "M.A., LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-01-02",
        "last_updated": "2018-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JIM GOETHEL",
            "last_name": "GOETHEL",
            "credential": "M.A., LMFT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.