Healthcare Provider Details

I. General information

NPI: 1073434890
Provider Name (Legal Business Name): IVONNE NMN GOETSCH PSYD, RPA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2026
Last Update Date: 07/25/2026
Certification Date: 07/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4213 STATE ST STE 302
SANTA BARBARA CA
93110-2859
US

IV. Provider business mailing address

4213 STATE ST STE 302
SANTA BARBARA CA
93110-2859
US

V. Phone/Fax

Practice location:
  • Phone: 805-500-3131
  • Fax: 805-626-8785
Mailing address:
  • Phone: 805-500-3131
  • Fax: 805-626-8785

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number94029694
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: