Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jesse Goodman, AGNP

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1609248202

Jesse Goodman, AGNP is a Nurse Practitioner in Irvine, California. Qualified in 2015, 11 years ago. Practices with Jason Kellogg MD Inc, an 18-clinician group, accepts Medicare assignment and offers telehealth. Licensed in California.

Years since qualifying
11
Licensed in
CA
In the registry since
2015
What do these letters mean?
AGNP — Adult-Gerontology Nurse Practitioner
A nurse practitioner focused on adults and older people.

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Practice location Address checks out

17782 Cowan Ste A
Irvine, CA 92614-6041
Phone: (949) 722-7118
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 95003286 (CA)

Record details

NPI number1609248202
Entity typeIndividual (Type 1)
GenderMale
Credentials AGNP
Sole proprietorNo
NPI enumeratedOctober 22, 2015
Last updated in NPPESMay 6, 2020
Certification dateMay 6, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice Jason Kellogg Md Inc — 18 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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