Basic Information
| Provider Information | |||||||||
| NPI: | 1588932271 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GOODEN | ||||||||
| FirstName: | TONI | ||||||||
| MiddleName: | R | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | LMFT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 439 FOREST PARK BLVD | ||||||||
| Address2: | |||||||||
| City: | OXNARD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 930365310 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8053910224 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1911 WILLIAMS DR STE B | ||||||||
| Address2: | |||||||||
| City: | OXNARD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 930362612 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8059814233 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/08/2011 | ||||||||
| LastUpdateDate: | 06/10/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 06/10/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | 56-03 | CA | N | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | 106H00000X | 107336 | CA | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.