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General NPI Number Information
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NPI Number | 1275432080
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Entity Type | Individual
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Provider Name | MADISON GOFFNER
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Gender | Female
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Dates
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Enumeration Date | 11/05/2026
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Last Update Date | 11/05/2026
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Provider Practice Location Address
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Address Line | 3231 OCEAN PARK BLVD STE 101
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City | SANTA MONICA
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State | CA
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Zip | 90405-3231
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Country | US
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Telephone | 929-260-1401
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Fax |
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Provider Business Mailing Address
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Address Line | 516 HANLEY PL
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City | LOS ANGELES
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State | CA
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Zip | 90049-1928
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 123891
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 138447
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License Number State | CA
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