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General NPI Number Information
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NPI Number | 1548381809
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Entity Type | Individual
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Provider Name | TABITHA WALDEN GOLDENBERG RN
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Gender | Female
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Dates
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Enumeration Date | 04/03/2007
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Last Update Date | 01/12/2009
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Provider Practice Location Address
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Address Line | 1340 ARNOLD DR STE 200
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City | MARTINEZ
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State | CA
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Zip | 94553-4189
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Country | US
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Telephone | 923-957-5128
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Fax |
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Provider Business Mailing Address
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Address Line | 1340 ARNOLD DR STE 200
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City | MARTINEZ
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State | CA
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Zip | 94553-4189
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Country | US
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Telephone | 923-957-5128
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 364SC1501X
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Taxonomy Name | Community Health/Public Health Clinical Nurse Specialist
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License Number | RN307403
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | 307403
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License Number State | CA
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