Basic Information
| Provider Information | |||||||||
| NPI: | 1194801100 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BRUCE | ||||||||
| FirstName: | NOAH | ||||||||
| MiddleName: | GOLDIN | ||||||||
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| Credential: | M.S. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 100 WILSON RD | ||||||||
| Address2: | STE 100 | ||||||||
| City: | MONTEREY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 939407885 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6505200464 | ||||||||
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| Practice Location | |||||||||
| Address1: | 355 ABBOTT ST STE 201 | ||||||||
| Address2: | |||||||||
| City: | SALINAS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 939014483 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8316247070 | ||||||||
| FaxNumber: | 8317517050 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/31/2006 | ||||||||
| LastUpdateDate: | 03/28/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC0700X | 23184 | CA | Y | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Psychologist | Clinical |
No ID Information.