Provider Demographics
NPI:1871656835
Name:GOLDSTEIN, ROZ C (ROZ MFT)
Entity Type:Individual
Prefix:MS
First Name:ROZ
Middle Name:C
Last Name:GOLDSTEIN
Suffix:
Gender:F
Credentials:ROZ MFT
Other - Prefix:
Other - First Name:ROZ
Other - Middle Name:
Other - Last Name:COBB
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ROZ
Mailing Address - Street 1:905 SIR FRANCIS DRAKE BLVD STE F
Mailing Address - Street 2:
Mailing Address - City:KENTFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94904-1589
Mailing Address - Country:US
Mailing Address - Phone:415-925-9520
Mailing Address - Fax:
Practice Address - Street 1:905 SIR FRANCIS DRAKE BLVD STE F
Practice Address - Street 2:
Practice Address - City:KENTFIELD
Practice Address - State:CA
Practice Address - Zip Code:94904-1589
Practice Address - Country:US
Practice Address - Phone:415-925-9520
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13284106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist