Individual
NICOLE GOODWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SOCIAL WORKER
Contact information
Practice address
784 HIGH ST, SAN LUIS OBISPO, CA 93401-5243
(805) 540-6500
Mailing address
784 HIGH ST, SAN LUIS OBISPO, CA 93401-5243
(805) 540-6500
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
PT31294
CA
373H00000X
Day Training/Habilitation Specialist
—
CA
Other
Enumeration date
12/05/2006
Last updated
10/21/2025
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