Shelby Goodwin
Student in an Organized Health Care Education/Training Program in Venice, CA. Individual provider (NPI-1).
NPI number1962294546
StatusActive
Last updated in NPPESSep 27, 2025
Details
- NPI
- 1962294546
- Entity type
- Individual (NPI-1)
- Name
- Shelby Goodwin
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- May 20, 2025
- Certification date
- Sep 27, 2025
- Last updated
- Sep 27, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
| 106S00000X | Behavior Technician | RBT-25-421477 | CA |
Practice location
204 Hampton DrVenice, CA 90291-2623
Phone 310-396-6468
Mailing address
1016 Tiverton AveLos Angeles, CA 90024-3073
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All 38 Student in an Organized Health Care Education/Training Program providers in Venice · All 751 providers in Venice
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