Provider Demographics
NPI:1619424199
Name:GOLDBERG, HANNAH LOWINGER (MSN,PNP-PC,PMHNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:HANNAH
Middle Name:LOWINGER
Last Name:GOLDBERG
Suffix:
Gender:F
Credentials:MSN,PNP-PC,PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1637 S HOLT AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90035-3612
Mailing Address - Country:US
Mailing Address - Phone:303-902-7779
Mailing Address - Fax:
Practice Address - Street 1:4650 W SUNSET BLVD # 167
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027-6062
Practice Address - Country:US
Practice Address - Phone:323-361-3500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-01
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP95004415363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner