Provider Demographics
NPI:1982183497
Name:GOLDSTEIN-SCHU, CARLY JANE (MS)
Entity Type:Individual
Prefix:MRS
First Name:CARLY
Middle Name:JANE
Last Name:GOLDSTEIN-SCHU
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MRS
Other - First Name:CARLY
Other - Middle Name:JANE GOLDSTEIN
Other - Last Name:SCHU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS
Mailing Address - Street 1:3950 T ST
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95819-4730
Mailing Address - Country:US
Mailing Address - Phone:619-786-6531
Mailing Address - Fax:
Practice Address - Street 1:3950 T ST
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95819-4730
Practice Address - Country:US
Practice Address - Phone:619-786-6531
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-07
Last Update Date:2021-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA118712106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist