Provider Demographics
NPI:1225219801
Name:G.O.A.L.S. FOR WOMEN
Entity Type:Organization
Organization Name:G.O.A.L.S. FOR WOMEN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE/CLINICAL DIRECTOR/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:GWENDOLYN
Authorized Official - Middle Name:ROCHELLE
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:MSW / LCSW
Authorized Official - Phone:510-334-0003
Mailing Address - Street 1:1217 DEL PASO BLVD STE A
Mailing Address - Street 2:OFFICE #3
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95815-2737
Mailing Address - Country:US
Mailing Address - Phone:916-754-7610
Mailing Address - Fax:888-847-9365
Practice Address - Street 1:3356 ADELINE ST
Practice Address - Street 2:OFFICE #3
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94703-2737
Practice Address - Country:US
Practice Address - Phone:510-334-0003
Practice Address - Fax:888-847-9365
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-23
Last Update Date:2017-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management