Individual provider · Type 1 NPI
Jaqueline Alexis Gorodetsky, PMHNP
Psychiatric/Mental Health Nurse Practitioner · Panorama City, CA
NPI number
1619730660
Active
Practice location
14860 Roscoe Blvd Ste 307
Panorama City, CA 91402-4691
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | 95027727 (CA) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
2 other providers at this address
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- Jennilyn Banal, PMHNPPsychiatric/Mental Health Nurse Practitioner Panorama City, CA NPI 1386315729
- Karima Ibrahim, PMHNP-BCPsychiatric/Mental Health Nurse Practitioner Panorama City, CA NPI 1922780188
About NPI 1619730660
Jaqueline Alexis Gorodetsky, PMHNP's National Provider Identifier is 1619730660, issued on Feb 2, 2024. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Panorama City, CA. The record was last updated on Jan 1, 2026.