Provider Demographics
NPI:1942338322
Name:GOLDBERG, RICHARD FREDRICK (MA)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:FREDRICK
Last Name:GOLDBERG
Suffix:
Gender:M
Credentials:MA
Other - Prefix:MR
Other - First Name:RICHARD
Other - Middle Name:FREDRICK
Other - Last Name:GOLDBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:4033 LA COLINA RD
Mailing Address - Street 2:
Mailing Address - City:EL SOBRANTE
Mailing Address - State:CA
Mailing Address - Zip Code:94803-2917
Mailing Address - Country:US
Mailing Address - Phone:925-431-2628
Mailing Address - Fax:925-431-2644
Practice Address - Street 1:2311 LOVERIDGE RD
Practice Address - Street 2:
Practice Address - City:PITTSBURG
Practice Address - State:CA
Practice Address - Zip Code:94565-5117
Practice Address - Country:US
Practice Address - Phone:925-431-2628
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health