Provider Demographics
NPI:1023228871
Name:GOLDBERG, LINDA LOU (NP)
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:LOU
Last Name:GOLDBERG
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5 BON AIR RD
Mailing Address - Street 2:SUITE 117
Mailing Address - City:LARKSPUR
Mailing Address - State:CA
Mailing Address - Zip Code:94939-1143
Mailing Address - Country:US
Mailing Address - Phone:415-924-9770
Mailing Address - Fax:415-924-8143
Practice Address - Street 1:5 BON AIR RD
Practice Address - Street 2:SUITE 117
Practice Address - City:LARKSPUR
Practice Address - State:CA
Practice Address - Zip Code:94939-1143
Practice Address - Country:US
Practice Address - Phone:415-924-9770
Practice Address - Fax:415-924-8143
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA257613363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health