Provider Demographics
NPI:1083955488
Name:GOLDSTEIN-BALL, JANET ELIZABETH (MFT, CEDS)
Entity Type:Individual
Prefix:MRS
First Name:JANET
Middle Name:ELIZABETH
Last Name:GOLDSTEIN-BALL
Suffix:
Gender:F
Credentials:MFT, CEDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11641 VALLEY SPRING LN APT 306
Mailing Address - Street 2:
Mailing Address - City:STUDIO CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91604-2892
Mailing Address - Country:US
Mailing Address - Phone:818-497-4098
Mailing Address - Fax:
Practice Address - Street 1:4405 W RIVERSIDE DR STE 106
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-4050
Practice Address - Country:US
Practice Address - Phone:818-497-7299
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-09
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC52401106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist