Provider Demographics
NPI:1619170719
Name:GOLDIN, RENEE MICHELE (RPT)
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:MICHELE
Last Name:GOLDIN
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:MISS
Other - First Name:RENEE
Other - Middle Name:MICHELE
Other - Last Name:REASONER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPT
Mailing Address - Street 1:22343 GOLDEN CANYON CIR
Mailing Address - Street 2:
Mailing Address - City:CHATSWORTH
Mailing Address - State:CA
Mailing Address - Zip Code:91311-1260
Mailing Address - Country:US
Mailing Address - Phone:818-775-0788
Mailing Address - Fax:
Practice Address - Street 1:27442 PORTOLA PKWY
Practice Address - Street 2:
Practice Address - City:FOOTHILL RANCH
Practice Address - State:CA
Practice Address - Zip Code:92610-2823
Practice Address - Country:US
Practice Address - Phone:949-282-5900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT9647225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist