Provider Demographics
NPI:1194907972
Name:GOLDSTEIN, MATTHEW ROBERT OLIVER
Entity type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:ROBERT OLIVER
Last Name:GOLDSTEIN
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:ROBERT
Other - Middle Name:OLIVER
Other - Last Name:GOLDSTEIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:368 FELL ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-5144
Mailing Address - Country:US
Mailing Address - Phone:415-861-0828
Mailing Address - Fax:415-861-0257
Practice Address - Street 1:1405 GUERRERO ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-4324
Practice Address - Country:US
Practice Address - Phone:415-821-0697
Practice Address - Fax:415-821-3568
Is Sole Proprietor?:No
Enumeration Date:2007-12-03
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor