Active NPI
Jennifer Rebecaa Goodman, MFT INTERN
- Rehabilitation Practitioner
- Riverside, CA
National Provider Identifier
1871862201
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Practitioner
- License
- 67359
- Practice address
- 3681 Sunnyside Dr # 20973
Riverside, CA 92506-2415 - Phone
- (951) 215-6398
- Fax
- (951) 222-2158
- NPI assigned
- Dec 13, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Practitioner | 225400000X | 67359 | CA | Primary |
Addresses
Primary practice location
3681 Sunnyside Dr # 20973
Riverside, CA 92506-2415
Mailing address
PO Box 20973
Riverside, CA 92516-0973
Phone (951) 215-6398
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 67359 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1323734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1764460800000",
"number": "1871862201",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 20973",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925160973",
"telephone_number": "951-215-6398",
"fax_number": "951-222-2158"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3681 SUNNYSIDE DR # 20973",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925062415",
"telephone_number": "951-215-6398",
"fax_number": "951-222-2158"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOODMAN",
"first_name": "JENNIFER",
"middle_name": "REBECAA",
"credential": "MFT INTERN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-12-13",
"last_updated": "2025-11-30",
"certification_date": "2025-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "225400000X",
"taxonomy_group": "",
"desc": "Rehabilitation Practitioner",
"state": "CA",
"license": "67359",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Riverside, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.