Healthcare Provider Details

I. General information

NPI: 1063584522
Provider Name (Legal Business Name): MONIKA GOEBEL LMFT, RDT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/13/2006
Last Update Date: 01/25/2023
Certification Date: 01/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1029 N BROADWAY
ESCONDIDO CA
92026-3043
US

IV. Provider business mailing address

4323 PARKS AVE APT 14
LA MESA CA
91941-6157
US

V. Phone/Fax

Practice location:
  • Phone: 760-669-7833
  • Fax:
Mailing address:
  • Phone: 805-748-2523
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101200000X
TaxonomyDrama Therapist
License Number448
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number48170
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: