Jaqueline Alexis Gorodetsky, PMHNP - Nurse Practitioner in Panorama City, CA

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Jaqueline Alexis Gorodetsky, PMHNP is a Nurse Practitioner - Psychiatric/mental Health based in Panorama City, California. Jaqueline Alexis Gorodetsky is licensed to practice in California (license number 95027727) and her current practice location is 14860 Roscoe Blvd Ste 307, Panorama City, California. She can be reached at her office (for appointments etc.) via phone at (818) 616-2122.

NPI number for Jaqueline Alexis Gorodetsky is 1619730660 and her current mailing address is 14860 Roscoe Blvd Ste 307, Panorama City, California. She does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1619730660.

Contact Information

Jaqueline Alexis Gorodetsky, PMHNP
14860 Roscoe Blvd Ste 307,
Panorama City, CA 91402-4691
(818) 616-2122
Not Available

Map and Direction




Provider's Profile

Full NameJaqueline Alexis Gorodetsky
GenderFemale
SpecialityNurse Practitioner - Psychiatric/mental Health
Location14860 Roscoe Blvd Ste 307, Panorama City, California
Accepts Medicare AssignmentsDoes not participate in Medicare Program. She may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1619730660
  • Provider Enumeration Date: 02/02/2024
  • Last Update Date: 01/01/2026

Medical Identifiers

Medical identifiers for Jaqueline Alexis Gorodetsky such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1619730660NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LP0808XNurse Practitioner - Psychiatric/mental Health 95027727 (California)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jaqueline Alexis Gorodetsky is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Jaqueline Alexis Gorodetsky, PMHNP
14860 Roscoe Blvd Ste 307,
Panorama City, CA 91402-4691

Ph: () -		Jaqueline Alexis Gorodetsky, PMHNP
14860 Roscoe Blvd Ste 307,
Panorama City, CA 91402-4691

Ph: (818) 616-2122

Reviews and Comments


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Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

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