Provider Demographics
NPI:1699983965
Name:GOULET, JOHN (LMFT)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:GOULET
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2021 SPERRY AVE
Mailing Address - Street 2:SUITE 9
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-7408
Mailing Address - Country:US
Mailing Address - Phone:805-656-2910
Mailing Address - Fax:805-650-1214
Practice Address - Street 1:2021 SPERRY AVE
Practice Address - Street 2:SUITE 9
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-7408
Practice Address - Country:US
Practice Address - Phone:805-656-2910
Practice Address - Fax:805-650-1214
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC20064106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist