Bryan Kieth Goudelock in Loma Linda - Psychologist
Bryan Kieth Goudelock - NPI 1467649202
Bryan Kieth Goudelock is a Psychologist in Loma Linda, California. Bryan Kieth Goudelock practices all healthcare services and medical treatments related to Psychologist. The NPI Number for Bryan Kieth Goudelock is 1467649202. The last update date is 2007-09-25.
Bryan Kieth Goudelock's current location address is 11201 Benton St, Loma Linda, California. You can contact this provider via phone number 9098257084. The mailing address for Bryan Kieth Goudelock is 11201 Benton St, Loma Linda, California. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Bryan Kieth Goudelock |
|---|---|
| Address | 11201 Benton St, Loma Linda, California |
| Phone Number | 9098257084 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | PH.D. |
NPI Number Detail
| NPI Number | 1467649202 |
|---|---|
| Provider Enumeration Date | 2007-09-25 |
| Last Updated Date | 2007-09-25 |
Provider Mailing Address Detail
| Address | 11201 Benton St |
|---|---|
| City | Loma Linda |
| State | California (CA) |
| Post Code | 923571000 |
| Phone Number | 9098257084 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Psychologist |
|---|---|
| Taxonomy | 103T00000X |
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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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What is the unique identifier code issued to Bryan Kieth Goudelock by the Centers for Medicare & Medicaid Services (CMS)?
The Bryan Kieth Goudelock has been assigned the NPI (National Provider Identifier) 1467649202. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Could you please provide the complete street address where Bryan Kieth Goudelock is physically located?
The Bryan Kieth Goudelock is physically situated at the following address: 11201 Benton St, Loma Linda, CA, 923571000.
What is Bryan Kieth Goudelock's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Bryan Kieth Goudelock is Psychologist, and the corresponding taxonomy classification code for this specialized field is 103T00000X.
On what date did the Centers for Medicare & Medicaid Services issue the 1467649202 to Bryan Kieth Goudelock?
The Bryan Kieth Goudelock received its 1467649202 assignment from the Centers for Medicare & Medicaid Services on 2007-09-25.
As of what date were the details pertaining to Bryan Kieth Goudelock last refreshed?
The information related to the Bryan Kieth Goudelock, including its address, specialty, and other relevant details, was last updated on 2007-09-25.