Provider Demographics
NPI:1699835892
Name:GOLDSTEIN, STEVEN R (PHD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:R
Last Name:GOLDSTEIN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2911 CANTEGRA GLEN
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92025
Mailing Address - Country:US
Mailing Address - Phone:858-674-9900
Mailing Address - Fax:858-674-9715
Practice Address - Street 1:16925 W BERNARDO DR
Practice Address - Street 2:SUITE 236 B
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92081
Practice Address - Country:US
Practice Address - Phone:858-674-9900
Practice Address - Fax:858-674-9715
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY3676103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACP3676Medicare ID - Type Unspecified