Provider Demographics
NPI:1194801100
Name:BRUCE, NOAH GOLDIN (MS)
Entity type:Individual
Prefix:
First Name:NOAH
Middle Name:GOLDIN
Last Name:BRUCE
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 WILSON RD
Mailing Address - Street 2:STE 100
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-7885
Mailing Address - Country:US
Mailing Address - Phone:650-520-0464
Mailing Address - Fax:
Practice Address - Street 1:355 ABBOTT ST STE 201
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-4483
Practice Address - Country:US
Practice Address - Phone:831-624-7070
Practice Address - Fax:831-751-7050
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-31
Last Update Date:2018-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23184103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty