Provider Demographics
NPI:1912448507
Name:GOLDMAN, JAIME A (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:JAIME
Middle Name:A
Last Name:GOLDMAN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7523 SOLANO ST
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92009-7529
Mailing Address - Country:US
Mailing Address - Phone:202-525-0599
Mailing Address - Fax:
Practice Address - Street 1:2236 ENCINITAS BLVD STE C-3
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-4352
Practice Address - Country:US
Practice Address - Phone:858-860-8876
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-15
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA293009225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist