Provider Demographics
NPI:1003448218
Name:JULIE GOALWIN, PH.D. A PSYCHOLOGICAL CORPORATION
Entity Type:Organization
Organization Name:JULIE GOALWIN, PH.D. A PSYCHOLOGICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GOALWIN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:562-364-8587
Mailing Address - Street 1:115 PINE AVE STE 640
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90802-4452
Mailing Address - Country:US
Mailing Address - Phone:562-364-8587
Mailing Address - Fax:562-364-8588
Practice Address - Street 1:115 PINE AVE STE 640
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90802-4452
Practice Address - Country:US
Practice Address - Phone:562-364-8587
Practice Address - Fax:562-364-8588
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-05
Last Update Date:2020-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty