Olga Yalyshava Goodman, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

69810 Issued in CA

Practice address

127 E Lexington Ave
El Cajon, CA 92020-4511

Phone

(619) 407-9383

NPI assigned

Jan 3, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Volha Yalyshava Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Feb 19, 2024 through Feb 19, 2028

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1294012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1821392002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 E LEXINGTON AVE",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920204511",
            "telephone_number": "619-407-9383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 E LEXINGTON AVE",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920204511",
            "telephone_number": "619-407-9383"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2525 Camino Del Rio S",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921083717",
            "country_code": "US",
            "telephone_number": "619-407-9383",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOODMAN",
        "first_name": "OLGA",
        "middle_name": "YALYSHAVA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-01-03",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "69810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VOLHA",
            "last_name": "YALYSHAVA",
            "credential": "LCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Good Samaritan Retirement Center
• Gregory Mathew Good
• Camille Goodin
• Allan H Goodman, MD
• Ann Goodman, LMFT
• Goodwin Rehab Enterprises, Inc.
• Carmen Goodwin
• Annie Gorbonosov
• Trishell Dawn Gorczyca, OTRL
• Christopher Jon Gordon, MD

• Clinical Social Worker in El Cajon, CA
• Providers in El Cajon, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.