Basic Information
| Provider Information | |||||||||
| NPI: | 1295866671 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GOLDIN | ||||||||
| FirstName: | DANIEL | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | I | ||||||||
| Credential: | M.A. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1223 SCENIC DR | ||||||||
| Address2: | |||||||||
| City: | GLENDALE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 912053743 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2324613161 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 6838 W SUNSET BLVD | ||||||||
| Address2: | BHS-HOLLYWOOD | ||||||||
| City: | HOLLYWOOD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900287008 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3234613161 | ||||||||
| FaxNumber: | 3234615683 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/08/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | 50691 | CA | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.