Provider Demographics
NPI:1295895589
Name:GOLDENHOLZ, NAVA (PHD)
Entity type:Individual
Prefix:DR
First Name:NAVA
Middle Name:
Last Name:GOLDENHOLZ
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3132 NW 88TH AVE
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33351-7333
Mailing Address - Country:US
Mailing Address - Phone:954-742-0797
Mailing Address - Fax:954-742-3093
Practice Address - Street 1:3132 NW 88TH AVE
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33351-7333
Practice Address - Country:US
Practice Address - Phone:954-742-0797
Practice Address - Fax:954-742-3093
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY3324103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL75921Medicare ID - Type UnspecifiedCLINICAL PSYCHOLOGIST