Healthcare Provider Details

I. General information

NPI: 1124948245
Provider Name (Legal Business Name): JANET GOODIS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JANDEE GOODIS OTR/L

II. Dates (important events)

Enumeration Date: 07/18/2026
Last Update Date: 07/18/2026
Certification Date: 07/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 6683
VENTURA CA
93006-6683
US

IV. Provider business mailing address

PO BOX 6683
VENTURA CA
93006-6683
US

V. Phone/Fax

Practice location:
  • Phone: 805-630-8151
  • Fax:
Mailing address:
  • Phone: 805-630-8151
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberOT4717
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: