Provider Demographics
NPI:1972329621
Name:GOLDBERGER, RYANA JANELLE (LCSW, ACHP-SW)
Entity type:Individual
Prefix:MRS
First Name:RYANA
Middle Name:JANELLE
Last Name:GOLDBERGER
Suffix:
Gender:F
Credentials:LCSW, ACHP-SW
Other - Prefix:
Other - First Name:RYANA
Other - Middle Name:JANELLE
Other - Last Name:KENELY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4269 CALLE ISABELINO
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92130-2656
Mailing Address - Country:US
Mailing Address - Phone:858-260-4081
Mailing Address - Fax:
Practice Address - Street 1:3252 HOLIDAY COURT
Practice Address - Street 2:SUITE 201
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-1808
Practice Address - Country:US
Practice Address - Phone:858-371-3737
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-26
Last Update Date:2024-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS231901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical