Individual
DR. JAKE PATRICK GOODMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
13319 POWAY RD, PMB #121, POWAY, CA 92064
(858) 463-4703
Mailing address
13319 POWAY RD, PMB #121, POWAY, CA 92064
(858) 463-4703
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
A200604
CA
Other
Enumeration date
03/22/2021
Last updated
06/17/2025
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