MEDICARE: DR. BARTON JAY GOLDSMITH PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	MFC 32379	CA

General Provider Information

NPI Number	:	1407061096
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BARTON JAY GOLDSMITH PH.D.

Provider Business Mailing Address
First Line	:	32129 LINDERO CANYON RD STE 210
Second Line	:
City	:	WESTLAKE VILLAGE
State	:	CA
Zip	:	91361-5429
Country	:	US
Telephone Number	:	818-879-9996
Fax Number	:	818-879-6502

Provider Business Practice Location Address
First Line	:	32129 LINDERO CANYON RD STE 210
Second Line	:
City	:	WESTLAKE VILLAGE
State	:	CA
Zip	:	91361-5429
Country	:	US
Telephone Number	:	818-879-9996
Fax Number	:	818-879-6502

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/14/2007
Last Update Date	:	07/08/2007

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