Individual provider · Type 1 NPI
Jesse Goodman, AGNP
Psychiatric/Mental Health Nurse Practitioner · Irvine, CA
NPI number
1609248202
Active
Practice location
17782 Cowan Ste A
Irvine, CA 92614-6041
Mailing address
28411 Pueblo Dr
Trabuco Canyon, CA 92679-1157
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | 95003286 (CA) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
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About NPI 1609248202
Jesse Goodman, AGNP's National Provider Identifier is 1609248202, issued on Oct 22, 2015. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Irvine, CA. The record was last updated on May 6, 2020.