Provider Demographics
NPI:1457010035
Name:GOLDENSON, DENNIS BERNARD
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:BERNARD
Last Name:GOLDENSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21859 YBARRA RD
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-4236
Mailing Address - Country:US
Mailing Address - Phone:818-371-9858
Mailing Address - Fax:
Practice Address - Street 1:5550 TOPANGA CANYON BLVD STE 300
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91367-7448
Practice Address - Country:US
Practice Address - Phone:818-674-9834
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-10
Last Update Date:2021-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA129432106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist