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1609248202
JESSE GOODMAN
IRVINE, CA
NPI
1609248202
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: CA 95003286)
Enumeration Date
2015-10-22
Last Update Date
2020-05-06
Business Address
JESSE GOODMAN AGNP
17782 COWAN STE A
IRVINE, CA 92614-6041
Phone number: 949-722-7118
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Mailing Address
JESSE GOODMAN AGNP
28411 PUEBLO DR
TRABUCO CANYON, CA 92679-1157
Phone number: 801-425-2831
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