Provider Demographics
NPI:1023269750
Name:GOETZ, JAMES KIMBALL (PSY D)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:KIMBALL
Last Name:GOETZ
Suffix:
Gender:M
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1194
Mailing Address - Street 2:
Mailing Address - City:INVERNESS
Mailing Address - State:CA
Mailing Address - Zip Code:94937-1194
Mailing Address - Country:US
Mailing Address - Phone:415-827-2163
Mailing Address - Fax:
Practice Address - Street 1:65 3RD STREET
Practice Address - Street 2:29 B
Practice Address - City:POINT REYES STATION
Practice Address - State:CA
Practice Address - Zip Code:94956
Practice Address - Country:US
Practice Address - Phone:415-827-2163
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-30
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 22070103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical