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NPI Code Detail

MEDICARE: DR. SCOTT ALAN GOODE PHD, PHD

MEDICARE: DR. SCOTT ALAN GOODE PHD, PHD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103T00000XPsychologistPSB94025027CA

General Provider Information

NPI Number : 1932759115
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SCOTT ALAN GOODE PHD, PHD
Provider Business Mailing Address
First Line : 27160 MOODY RD
Second Line :
City : LOS ALTOS HILLS
State : CA
Zip : 94022-4240
Country : US
Telephone Number : 650-209-4271
Fax Number :
Provider Business Practice Location Address
First Line : 617 VETERANS BLVD STE 204
Second Line :
City : REDWOOD CITY
State : CA
Zip : 94063-1419
Country : US
Telephone Number : 650-503-8179
Fax Number : 650-679-8052
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/18/2019
Last Update Date : 09/18/2019

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