Individual provider Active NPI

David Douglas Goodison

  • Peer Specialist
  • Grass Valley, CA
National Provider Identifier
1710798483
Registry record updated Sep 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
License
MPSS-CENUVM Issued in CA
Practice address
500 Crown Point Cir Ste 120
Grass Valley, CA 95945-9561
Phone
(530) 273-5440
Fax
(530) 273-5479
NPI assigned
Jan 14, 2025
Last updated
Sep 4, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X MPSS-CENUVM CA Primary

Addresses

Primary practice location

500 Crown Point Cir Ste 120
Grass Valley, CA 95945-9561

Mailing address

500 Crown Point Cir Ste 120
Grass Valley, CA 95945-9561
Phone (530) 265-1437

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

NPI Registry JSON

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

{
    "created_epoch": "1736812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788480000000",
    "number": "1710798483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 CROWN POINT CIR STE 120",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959459561",
            "telephone_number": "530-265-1437",
            "fax_number": "530-271-0257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 CROWN POINT CIR STE 120",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959459561",
            "telephone_number": "530-273-5440",
            "fax_number": "530-273-5479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODISON",
        "first_name": "DAVID",
        "middle_name": "DOUGLAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-01-14",
        "last_updated": "2026-09-04",
        "certification_date": "2026-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "CA",
            "license": "MPSS-CENUVM",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grass Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2026; 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.