Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 27268 | CA |
Y | 103TC0700X | Clinical Psychologist | 27268 | CA |
N | 225C00000X | Rehabilitation Counselor |
NPI | 1134403793 |
---|---|
Provider Name | Dr. Charlene T Goodman |
First Address | Northridge, CA 91325-1677 |
Second Address | Los Angeles, CA 90044-3422 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/09/2011 |
Last Update Date | 20/04/2021 |