Healthcare Provider Details
I. General information
NPI: 1215854377
Provider Name (Legal Business Name): EMMA GOODFIELD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 06/30/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1600 SHATTUCK AVE STE 200
BERKELEY CA
94709-1601
US
IV. Provider business mailing address
1666 HAIGHT ST
SAN FRANCISCO CA
94117-2816
US
V. Phone/Fax
- Phone: 415-409-8640
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | AMFT156431 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: