Provider Demographics
NPI:1639730872
Name:GOLDSTEIN, BARRY SETH (PSYD)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:SETH
Last Name:GOLDSTEIN
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4214 ELENDA ST
Mailing Address - Street 2:
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90230-3752
Mailing Address - Country:US
Mailing Address - Phone:323-806-8030
Mailing Address - Fax:
Practice Address - Street 1:12512 W WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90066-5506
Practice Address - Country:US
Practice Address - Phone:323-806-8030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-27
Last Update Date:2019-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17020103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical