Provider Demographics
NPI:1548274541
Name:GOODE, FRANCES (MFT)
Entity type:Individual
Prefix:
First Name:FRANCES
Middle Name:
Last Name:GOODE
Suffix:
Gender:F
Credentials:MFT
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 265
Mailing Address - Street 2:
Mailing Address - City:DIAMOND SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:95619-0265
Mailing Address - Country:US
Mailing Address - Phone:530-295-1742
Mailing Address - Fax:530-626-6891
Practice Address - Street 1:504 MAIN ST
Practice Address - Street 2:
Practice Address - City:DIAMOND SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:95619-9109
Practice Address - Country:US
Practice Address - Phone:530-295-1742
Practice Address - Fax:530-626-6891
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC29496106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist