=====================================================
General NPI Number Information
=====================================================
NPI Number | 1215805247
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | GOODNESS VILLAGE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/29/2025
-----------------------------------------------------
Last Update Date | 10/29/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1646 FREISMAN RD
-----------------------------------------------------
City | LIVERMORE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94551-8400
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 925-237-1108
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1660 FREISMAN RD
-----------------------------------------------------
City | LIVERMORE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94551-8416
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 925-237-1108
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | EXECUTIVE DIRECTOR
-----------------------------------------------------
Name | DR. KIMBERLY MAE CURTIS
-----------------------------------------------------
Credential | DHS, LCSW
-----------------------------------------------------
Telephone | 925-237-1108
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------