Provider Demographics
NPI:1770193773
Name:GOLDSTEIN, JOSHUA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:
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 1:420 S BEVERLY DR STE 100-8
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212-4426
Mailing Address - Country:US
Mailing Address - Phone:310-729-4142
Mailing Address - Fax:
Practice Address - Street 1:420 S BEVERLY DR STE 100-8
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-4426
Practice Address - Country:US
Practice Address - Phone:310-729-4142
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-04
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31942103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical