| Marcie I. Goldman, Ph.d, Psychologist, Inc. | |
|
4452 Park Blvd Ste 101 San Diego CA 92116-4039 | |
| (619) 952-8077 | |
| Not Available |
| Full Name | Marcie I. Goldman, Ph.d, Psychologist, Inc. |
|---|---|
| Speciality | Psychologist |
| Location | 4452 Park Blvd Ste 101, San Diego, California |
| Authorized Official Name and Position | Marcie Ilene Goldman (CEO/ PSYCHOLOGIST) |
| Authorized Official Contact | 6199528077 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Marcie I. Goldman, Ph.d, Psychologist, Inc. 1332 Bancroft St San Diego CA 92102-2430 Ph: (619) 952-8077 | Marcie I. Goldman, Ph.d, Psychologist, Inc. 4452 Park Blvd Ste 101 San Diego CA 92116-4039 Ph: (619) 952-8077 |
| NPI Number | 1578885513 |
|---|---|
| Provider Enumeration Date | 02/18/2010 |
| Last Update Date | 02/18/2010 |
| Medicare PECOS PAC ID | 1850435447 |
|---|---|
| Medicare Enrollment ID | O20100220000012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578885513 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | PSY14404 (California) | Primary |
| Provider Name | Marcie I Goldman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1427150879 PECOS PAC ID: 0941344535 Enrollment ID: I20100220000011 |
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