Healthcare Provider Details

I. General information

NPI: 1861011959
Provider Name (Legal Business Name): DANIELLE M GOLOMB MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2020
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 BUSH ST STE 230
SAN FRANCISCO CA
94109-5239
US

IV. Provider business mailing address

1801 BUSH ST STE 230
SAN FRANCISCO CA
94109-5239
US

V. Phone/Fax

Practice location:
  • Phone: 415-300-0499
  • Fax: 914-222-8995
Mailing address:
  • Phone: 415-300-0499
  • Fax: 914-222-8995

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA189932
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: