Provider Demographics
NPI:1770790206
Name:GOLDEN, CAROLYN (BS)
Entity type:Individual
Prefix:MRS
First Name:CAROLYN
Middle Name:
Last Name:GOLDEN
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1617 E SAGINAW WAY
Mailing Address - Street 2:STE. #109
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93704-4458
Mailing Address - Country:US
Mailing Address - Phone:559-241-0364
Mailing Address - Fax:559-241-0342
Practice Address - Street 1:1617 E SAGINAW WAY
Practice Address - Street 2:STE. #109
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93704-4458
Practice Address - Country:US
Practice Address - Phone:559-241-0364
Practice Address - Fax:559-241-0342
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)