| Joalla H Gold, Licensed Clinical Social Worker, Inc | |
|
10649 Riverside Dr Toluca Lake CA 91602-2341 | |
| (818) 789-5122 | |
| (818) 888-7089 |
| Full Name | Joalla H Gold, Licensed Clinical Social Worker, Inc |
|---|---|
| Speciality | Social Worker |
| Location | 10649 Riverside Dr, Toluca Lake, California |
| Authorized Official Name and Position | Joalla H Gold (PRESIDENT) |
| Authorized Official Contact | 8186455195 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Joalla H Gold, Licensed Clinical Social Worker, Inc 5239 Tendilla Ave Woodland Hills CA 91364-1830 Ph: (818) 645-5195 | Joalla H Gold, Licensed Clinical Social Worker, Inc 10649 Riverside Dr Toluca Lake CA 91602-2341 Ph: (818) 789-5122 |
| NPI Number | 1902519051 |
|---|---|
| Provider Enumeration Date | 01/04/2023 |
| Last Update Date | 01/04/2023 |
| Certification Date | 01/04/2023 |
| Medicare PECOS PAC ID | 1254705700 |
|---|---|
| Medicare Enrollment ID | O20230323001207 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902519051 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Joalla Gold |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356417141 PECOS PAC ID: 2163896614 Enrollment ID: I20230323001294 |
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