Healthcare Provider Details

I. General information

NPI: 1619883758
Provider Name (Legal Business Name): RICHARD GOLDWASSER, MD AND ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

655 REDWOOD HWY FRONTAGE RD STE 261
MILL VALLEY CA
94941-3011
US

IV. Provider business mailing address

70 MITCHELL BLVD STE 106
SAN RAFAEL CA
94903-2019
US

V. Phone/Fax

Practice location:
  • Phone: 415-479-6000
  • Fax: 415-507-2169
Mailing address:
  • Phone: 415-479-6000
  • Fax: 415-507-2169

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: RICHARD GOLDWASSER
Title or Position: DOCTOR
Credential: MD
Phone: 415-479-6000