Healthcare Provider Details
I. General information
NPI: 1598678559
Provider Name (Legal Business Name): KATJA GOLDSBERRY
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
23822 VALENCIA BLVD STE 305
VALENCIA CA
91355-5354
US
IV. Provider business mailing address
1093 WILSON DR
SIMI VALLEY CA
93065-5109
US
V. Phone/Fax
- Phone: 181-872-3423
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2355S0801X |
| Taxonomy | Speech-Language Assistant |
| License Number | 10001 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: