Provider Demographics
NPI:1710089628
Name:GOLDMAN, DARYL-ANNE (PHD)
Entity Type:Individual
Prefix:DR
First Name:DARYL-ANNE
Middle Name:
Last Name:GOLDMAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1231 MARKET ST
Mailing Address - Street 2:SUITE 810
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-1400
Mailing Address - Country:US
Mailing Address - Phone:415-337-4519
Mailing Address - Fax:510-531-5632
Practice Address - Street 1:1231 MARKET ST
Practice Address - Street 2:SUITE 810
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-1400
Practice Address - Country:US
Practice Address - Phone:415-337-4519
Practice Address - Fax:510-531-5632
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-01
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY9504103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00PL95040Medicare ID - Type Unspecified
CAR26436Medicare UPIN