Goodman, Amy D
Goodman, Amy D is an sole proprietor health care provider with primary practice located at 1375 Oakwood Ct , San Luis Obispo CA 93401-5918. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, Ambulatory Health Care Facilities / Clinic/Center. Ambulatory Health Care Facilities / Clinic/Center is her primary health care specialty. Goodman, Amy D can be contacted via phone (970) 379-5531.Contact Information
Primary practice address
1375 Oakwood Ct
San Luis Obispo CA 93401-5918
Phone: (970) 379-5531
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered | 367500000X | CRNA000233 | Nevada |
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered | 367500000X | CRNA-183907 | Colorado |
Ambulatory Health Care Facilities / Clinic/Center | 261Q00000X | 2974 | California |
Profile Details
NPI number | 1942292701 |
---|---|
LBN Legal business name | Goodman, Amy D |
Credentials | Certified Registered Nurse Anesthetist (CRNA) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Aug 18th, 2005 |
Last updated | Jun 1st, 2016 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1942292701 | NPPES |
Nevada | MEDICAID | 100503782 |
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