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Sophia Evelyn Mimi Goldberg
Student in an Organized Health Care Education/Training Program in Richmond, California
NPI 1942729074

Sophia Evelyn Mimi Goldberg is a Student in an Organized Health Care Education/Training Program based in Richmond, CA. Sophia Evelyn Mimi Goldberg practices in Richmond, CA. The NPI Number for Sophia Evelyn Mimi Goldberg is 1942729074 and holds a License No. (California).

The current practice location address for Sophia Evelyn Mimi Goldberg is 4101 Macdonald Ave, Richmond, CA and can be reached out via phone at 510-412-9200.

Location: 4101 Macdonald Ave, Richmond, CA, 94805-2333
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1942729074
Provider Name
Sophia Evelyn Mimi Goldberg
Credential
Provider Entity Type
Individual
Gender
Female
Address
4101 Macdonald Ave, Richmond, CA, 94805-2333
Phone Number
510-412-9200
Fax Number
Provider Enumeration Date
09/09/2017
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
900141226 01 WA UNITED HEALTHCARE
institution
Provider Business Practice Location Address Details
Address
4101 Macdonald Ave
City
Richmond
State
California
Zip
94805-2333
Phone Number
510-412-9200
Fax Number
person
Provider Business Mailing Address Details
Address
4101 Macdonald Ave
City
Richmond
State
California
Zip
94805-2333
Phone Number
510-412-9200
Fax Number
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Mental Health (Including Community Mental Health Center)
Taxonomy
261QM0801X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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