Healthcare Provider Details

I. General information

NPI: 1104237759
Provider Name (Legal Business Name): BARBARA JOAN GOEMAN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2014
Last Update Date: 05/16/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

535 W MATHEWS RD
FRENCH CAMP CA
95231-9757
US

IV. Provider business mailing address

535 W MATHEWS RD
FRENCH CAMP CA
95231-9757
US

V. Phone/Fax

Practice location:
  • Phone: 209-468-4246
  • Fax: 209-468-4043
Mailing address:
  • Phone: 209-468-4246
  • Fax: 209-468-4043

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0807X
TaxonomyChild & Adolescent Psychiatric/Mental Health Registered Nurse
License Number773135
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: