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General NPI Number Information
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NPI Number | 1700363231
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Entity Type | Individual
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Provider Name | JONATHAN GOOBLAR PH.D.
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Gender | Male
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Dates
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Enumeration Date | 07/26/2018
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Last Update Date | 07/17/2025
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Provider Practice Location Address
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Address Line | 500 PATERSON PLANK RD STE 31038
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City | UNION CITY
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State | NJ
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Zip | 07087-3416
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Country | US
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Telephone | 415-723-0408
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Fax |
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Provider Business Mailing Address
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Address Line | 500 PATERSON PLANK RD STE 31038
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City | UNION CITY
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State | NJ
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Zip | 07087-3416
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Country | US
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Telephone | 415-723-0408
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 30227
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License Number State | CA
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