NATHANIEL VAN GOODLOW


Address: 433 Callan Ave, Suite 307, San Leandro, CA 94577-4643
Phone: 5103106994

NATHANIEL VAN GOODLOW (NPI# 1528278561) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1528278561
Entity Type Individual
Full Name NATHANIEL VAN GOODLOW
Credential PH.D.
Practice Address 433 Callan Ave
Suite 307
San Leandro
CA 94577-4643
Practice Telephone 5103106994
Enumeration Date 2007-05-22
Last Update Date 2007-07-09
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 103TP0016X Psychologist
Specialization: Prescribing (Medical)
PSY14990 CA Behavioral Health & Social Service Providers

Office Location

Street Address 433 CALLAN AVE
SUITE 307
City SAN LEANDRO
State CA
Zip Code 94577-4643

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1922023241 Ida M. Roberts Psychologist 433 Callan Ave, Ste 203, San Leandro, CA 94577-4643 2006-07-13
1083093199 K Whitaker Inc Counselor 433 Callan Ave, Ste 209, San Leandro, CA 94577-4643 2015-05-21
1790190866 Ward Chiropractic Chiropractor 433 Callan Ave, Ste 104, San Leandro, CA 94577-4643 2014-06-26
1265681886 Mariana Cazares Acupuncturist 433 Callan Ave, San Leandro, CA 94577-4643 2008-09-18
1972623858 Jason Su Acupuncturist 433 Callan Ave, Suite 204, San Leandro, CA 94577-4643 2007-04-02
1437276292 Jooske Annie Stil Counselor 433 Callan Ave, Suite 104, San Leandro, CA 94577-4643 2007-03-24
1376614388 Cynthia Renee Ward Chiropractor 433 Callan Ave, Ste. 104, San Leandro, CA 94577-4643 2006-11-13
1285704064 Juan Jose Lopez Chiropractor 433 Callan Ave, Suite 104, San Leandro, CA 94577-4643 2006-11-08

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Taxonomy Information

Taxonomy Code 103TP0016X
Grouping Behavioral Health & Social Service Providers
Classification Psychologist
Specialization Prescribing (Medical)

Taxonomy Definition

Those licensed psychologists who have completed specialized, post-doctoral training in psychopharmacology, passed a national proficiency examination in psychopharmacology, and who are authorized by state statute to prescribe medications, in accordance with their state law and state licensing authority, for the evaluation, diagnosis, management and treatment of mental, nervous, emotional, behavioral, and related disorders.
Notes: Source: Louisiana Academy of Medical Psychologists Note: Some states issue licenses under Medical Psychologist. [1/1/2007: new]

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1932320389 Ricque L. Brister Psychologist 56 Hanover Ln, Suite., 100, Chico, CA 95973-7230 2007-05-02
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Competitor

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City SAN LEANDRO
Zip Code 94577

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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