Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | 257613 | CA |
NPI | 1023228871 |
---|---|
Provider Name | Mrs. Linda Lou Goldberg |
First Address | Larkspur, CA 94939-1143 |
Second Address | Larkspur, CA 94939-1143 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2007 |
Last Update Date | 08/07/2007 |