Active NPI
Elizabeth Lena Gooding
- Clinical Psychologist
- San Jose, CA
National Provider Identifier
1932356128
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY26978
- Practice address
- 1101 S Winchester Blvd Ste A101
San Jose, CA 95128-3914 - Phone
- (408) 874-6470
- NPI assigned
- Aug 19, 2008
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY26978 | CA | Primary |
Addresses
Primary practice location
1101 S Winchester Blvd Ste A101
San Jose, CA 95128-3914
Mailing address
1101 S Winchester Blvd Ste A101
San Jose, CA 95128-3914
Phone (408) 874-6470
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932356128 | Other | CA | SELF |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY26978 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1219104000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1458345600000",
"number": "1932356128",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1101 S WINCHESTER BLVD STE A101",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951283914",
"telephone_number": "408-874-6470"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1101 S WINCHESTER BLVD STE A101",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951283914",
"telephone_number": "408-874-6470"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOODING",
"first_name": "ELIZABETH",
"middle_name": "LENA",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-08-19",
"last_updated": "2016-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY26978",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SELF",
"identifier": "1932356128",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 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.