MEDICARE: MR. KENNETH JAY GOODMAN L.C.S.W.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	LCS15866	CA

General Provider Information

NPI Number	:	1598735037
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. KENNETH JAY GOODMAN L.C.S.W.

Provider Business Mailing Address
First Line	:	18546 ROSCOE BLVD.
Second Line	:	SUITE 210
City	:	NORTHRIDGE
State	:	CA
Zip	:	91324
Country	:	US
Telephone Number	:	818-542-7925
Fax Number	:

Provider Business Practice Location Address
First Line	:	18546 ROSCOE BLVD
Second Line	:	SUITE 210
City	:	NORTHRIDGE
State	:	CA
Zip	:	91324-4663
Country	:	US
Telephone Number	:	818-542-7925
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/26/2006
Last Update Date	:	07/08/2007

Similar Medicare Providers

1700035193 — STEFANIE A PROIA CPNP
Practice Location Address:

18546 ROSCOE BLVD , SUITE 211
NORTHRIDGE, CA
91324-4663

Practice Phone: 818-885-8040
Practice Fax: 818-267-5633

1730177932 — MR. LAWRENCE OSMAN MD
Practice Location Address:

18546 ROSCOE BLVD , STE 306
NORTHRIDGE, CA
91324-4663

Practice Phone: 818-885-0455
Practice Fax: 818-701-8045

1881653590 — MRS. JIRAIR BOGHOS KONIALIAN MD
Practice Location Address:

18546 ROSCOE BLVD , SUITE 220
NORTHRIDGE, CA
91324-4663

Practice Phone: 818-886-0600
Practice Fax: 818-701-8100

1134164700 — KIDNEY DIALYSIS CENTER OF NORTHRIDGE,LLC
Practice Location Address:

18546 ROSCOE BLVD , SUITE # 108
NORTHRIDGE, CA
91324-4663

Practice Phone: 818-886-3771
Practice Fax: 818-886-5734

1194758664 — DIANA K SHORE
Practice Location Address:

18546 ROSCOE BLVD , SUITE 230
NORTHRIDGE, CA
91324-4663

Practice Phone: 818-886-1100
Practice Fax: 818-886-7501

1295750529 — PHILIP S SHORE MD
Practice Location Address:

18546 ROSCOE BLVD , SUITE 230
NORTHRIDGE, CA
91324-4663

Practice Phone: 818-886-1100
Practice Fax: 818-886-7501

Directions to “ MR. KENNETH JAY GOODMAN L.C.S.W.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.