Provider Demographics
NPI:1073799169
Name:GOLDEN, RICHARD LEE (PHD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:LEE
Last Name:GOLDEN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20740 MARTHA ST
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91367-6728
Mailing Address - Country:US
Mailing Address - Phone:818-884-8557
Mailing Address - Fax:818-884-3042
Practice Address - Street 1:20740 MARTHA ST
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91367-6728
Practice Address - Country:US
Practice Address - Phone:818-884-8557
Practice Address - Fax:818-884-3042
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-18
Last Update Date:2008-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC14642106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist