C. Draven Godwin Psychology

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

PSY21516 Issued in CA

Legal business name

C. DRAVEN GODWIN PSYCHOLOGY

Practice address

4370 Tujunga Ave Ste 150
Studio City, CA 91604-2753

Phone

(310) 795-4428

Fax

(818) 396-3173

NPI assigned

Sep 22, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Christian Draven Godwin, M.ED., PH.D.

Title

Psychologist

Phone

(323) 610-9107

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1474502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474502400000",
    "number": "1750830493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4370 TUJUNGA AVE STE 150",
            "city": "STUDIO CITY",
            "state": "CA",
            "postal_code": "916042753",
            "telephone_number": "310-795-4428",
            "fax_number": "818-396-3173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4370 TUJUNGA AVE STE 150",
            "city": "STUDIO CITY",
            "state": "CA",
            "postal_code": "916042753",
            "telephone_number": "310-795-4428",
            "fax_number": "818-396-3173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "C. DRAVEN GODWIN PSYCHOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-22",
        "last_updated": "2016-09-22",
        "status": "A",
        "authorized_official_last_name": "GODWIN",
        "authorized_official_first_name": "CHRISTIAN",
        "authorized_official_middle_name": "DRAVEN",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "323-610-9107",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.ED., PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "CA",
            "license": "PSY21516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Child & Adolescent Psychologist in Studio City, CA
• Providers in Studio City, CA by specialty
• Clinical Child & Adolescent Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 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.