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1124137765
JERRY M GOFFMAN
RANCHO CUCAMONGA, CA
NPI
1124137765
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
103T00000X Psychologist
(Licence: CA psy7081)
Enumeration Date
2006-08-29
Last Update Date
2007-10-01
Business Address
Dr. JERRY M GOFFMAN PhD.
8253 WHITE OAK AVE
RANCHO CUCAMONGA, CA 91730-7671
Phone number: 951-312-1041
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Mailing Address
Dr. JERRY M GOFFMAN PhD.
1040 S MOUNT VERNON AVE G-306
COLTON, CA 92324-4228
Phone number: 951-312-1041
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