Provider Demographics
NPI:1356417141
Name:GOLD, JOALLA (LCSW)
Entity type:Individual
Prefix:
First Name:JOALLA
Middle Name:
Last Name:GOLD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10649 RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:TOLUCA LAKE
Mailing Address - State:CA
Mailing Address - Zip Code:91602-2341
Mailing Address - Country:US
Mailing Address - Phone:818-789-5122
Mailing Address - Fax:818-888-7089
Practice Address - Street 1:10649 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:TOLUCA LAKE
Practice Address - State:CA
Practice Address - Zip Code:91602-2341
Practice Address - Country:US
Practice Address - Phone:818-789-5122
Practice Address - Fax:818-888-7089
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-26
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS146731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical