Provider Demographics
NPI:1023189578
Name:GOLDSTEIN, LINDA BENCANGEY (MA, MFT, REAT)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:BENCANGEY
Last Name:GOLDSTEIN
Suffix:
Gender:F
Credentials:MA, MFT, REAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 TROON WAY
Mailing Address - Street 2:
Mailing Address - City:HALF MOON BAY
Mailing Address - State:CA
Mailing Address - Zip Code:94019-2295
Mailing Address - Country:US
Mailing Address - Phone:650-726-0632
Mailing Address - Fax:650-726-0632
Practice Address - Street 1:3 WATERS PARK DR
Practice Address - Street 2:SUITE 233
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94403-1160
Practice Address - Country:US
Practice Address - Phone:650-357-8152
Practice Address - Fax:650-726-0632
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC33861106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist