Marie Rallie Goodson, MS-CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SP8945 Issued in CA

Practice address

54885 Avenida Carranza
La Quinta, CA 92253-3745

Phone

(760) 775-8160

Fax

(760) 775-8483

NPI assigned

Aug 19, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Rallie Ljuba Other name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Baldwin Park, CA
  • NPI 1770515280

  CA

  Medicare reassignment NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Los Angeles, CA
  • NPI 1013409044
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Santa Clarita, CA
  • NPI 1316409410
  NPD

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

{
    "created_epoch": "1219104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640044800000",
    "number": "1982851200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54885 AVENIDA CARRANZA",
            "city": "LA QUINTA",
            "state": "CA",
            "postal_code": "922533745",
            "telephone_number": "310-387-0740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54885 AVENIDA CARRANZA",
            "city": "LA QUINTA",
            "state": "CA",
            "postal_code": "922533745",
            "telephone_number": "760-775-8160",
            "fax_number": "760-775-8483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODSON",
        "first_name": "MARIE",
        "middle_name": "RALLIE",
        "credential": "MS-CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-19",
        "last_updated": "2021-12-21",
        "certification_date": "2021-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "SP8945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "9400 Rosecrans Ave",
            "city": "Bellflower",
            "state": "CA",
            "country_code": "US",
            "postal_code": "907062246",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "RALLIE",
            "last_name": "LJUBA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Lanae Glosson
• Juan Antonio Godoy, CADC II
• Emily Mariah Gonzalez Poulos
• Wilver Israel Gonzalez-Galdamez, DPT
• Edith Gonzalez-Werner, M. D.
• Steven P Gorman, M.D.
• Judith Granados
• Angela Rae Grano, SLP
• Greatfaith Managed Care Inc.
• Green River Hospice

• Speech-Language Pathologist in La Quinta, CA
• Providers in La Quinta, CA by specialty
• Speech-Language Pathologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.