Organization
COASTAL CENTER FOR ANXIETY TREATMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ERIC D GOODMAN PHD (DIRECTOR)
(805) 473-3388
Entity
Organization
Contact information
Practice address
1194 PACIFIC ST STE 101, SUITE B-2, SAN LUIS OBISPO, CA 93401-3338
(805) 473-3388
(805) 548-0815
Mailing address
1194 PACIFIC ST STE 101, SUITE B-2, SAN LUIS OBISPO, CA 93401-3338
(805) 473-3388
(805) 548-0815
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY20248
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PSY20248
MEDICAL LICENSE NUMBER
CA
Enumeration date
01/17/2007
Last updated
06/21/2013
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