Jerry M Goffman is a Psychologist in Colton, California. Jerry M Goffman practices all healthcare services and medical treatments related to Psychologist. The NPI Number for Jerry M Goffman is 1124137765. The last update date is 2007-10-01.
Jerry M Goffman's current location address is 1040 S Mount Vernon Ave, Colton, California. You can contact this provider via phone number 9513121041. The mailing address for Jerry M Goffman is 1040 S Mount Vernon Ave, Colton, California. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jerry M Goffman |
|---|---|
| Address | 1040 S Mount Vernon Ave, Colton, California |
| Phone Number | 9513121041 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | PHD. |
NPI Number Detail
| NPI Number | 1124137765 |
|---|---|
| Provider Enumeration Date | 2006-08-29 |
| Last Updated Date | 2007-10-01 |
Provider Mailing Address Detail
| Address | 1040 S Mount Vernon Ave |
|---|---|
| City | Colton |
| State | California (CA) |
| Post Code | 923244228 |
| Phone Number | 9513121041 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Psychologist |
|---|---|
| Taxonomy | 103T00000X |
| Licence No | PSY7081 |
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Definition: A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and proce |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| PSY070812 | CA | -- | |
| PSY070811 | CA | -- |
Post Comment/ Review Below
What is the unique identifier code issued to Jerry M Goffman by the Centers for Medicare & Medicaid Services?
The Jerry M Goffman has been assigned the NPI (National Provider Identifier) 1124137765. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you please share the complete physical address where Jerry M Goffman is geographically located?
The Jerry M Goffman is physically situated at the following location: 1040 S Mount Vernon Ave, Colton, CA, 923244228.
What is Jerry M Goffman's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Jerry M Goffman's specialized field of practice is Psychologist, and the corresponding taxonomy code that categorizes this area of specialization is 103T00000X.
On what date did the Jerry M Goffman receive its 1124137765 assignment from the Centers for Medicare & Medicaid Services?
The Jerry M Goffman was assigned its 1124137765 by the Centers for Medicare & Medicaid Services on 2006-08-29.
As of what date were the details related to Jerry M Goffman most recently updated or revised?
The information pertaining to Jerry M Goffman, including its address, specialty, and other relevant details, was last updated or revised on 2007-10-01.
NPI Number: 1336141779
Address: Po Box 246, Duffield, VA