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General NPI Number Information
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NPI Number | 1023342805
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Entity Type | Organization
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Legal Business Name | DON M GOODMAN INC.
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Dates
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Enumeration Date | 09/25/2009
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Last Update Date | 03/11/2024
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Provider Practice Location Address
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Address Line | 123 HODENCAMP RD STE 103
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City | THOUSAND OAKS
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State | CA
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Zip | 91360-5833
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Country | US
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Telephone | 818-917-4524
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Fax | 800-878-7720
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Provider Business Mailing Address
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Address Line | 123 HODENCAMP RD STE 103
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City | THOUSAND OAKS
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State | CA
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Zip | 91360-5833
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Country | US
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Telephone | 818-917-4524
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Fax | 805-449-2942
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | DR. DONALD MITCHELL GOODMAN
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Credential | PH.D.
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Telephone | 818-917-4524
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number | PSY 22613
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 103TH0004X
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Taxonomy Name | Health Psychologist
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License Number | PSY 22613
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 103TP2701X
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Taxonomy Name | Group Psychotherapy Psychologist
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License Number | PSY 22613
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY 22613
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License Number State | CA
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