Shane Goldbach

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

131450 Issued in CA

Practice address

50100 Golsh Rd
Valley Center, CA 92082-5338

Phone

(760) 749-1410

NPI assigned

Sep 13, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Victor Community Support Services, Inc.

  • Community/Behavioral Health Agency
  • Perris, CA
  • NPI 1629240270
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1189641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769126400000",
    "number": "1053506832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 N PERRIS BLVD",
            "address_2": "BUILDING A",
            "city": "PERRIS",
            "state": "CA",
            "postal_code": "925712811",
            "telephone_number": "951-436-5300",
            "fax_number": "951-436-5350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50100 GOLSH RD",
            "city": "VALLEY CENTER",
            "state": "CA",
            "postal_code": "920825338",
            "telephone_number": "760-749-1410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDBACH",
        "first_name": "SHANE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-09-13",
        "last_updated": "2026-01-23",
        "certification_date": "2026-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "131450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Excelencia Behavioral Therapy
• Misty Faulkner, RDN
• Firouzeh Alexandria Gamble, NP
• Maria De Jesus Garcia, BBH
• Dianne Lavine Ghosh
• Paul Anthony Gonzalez, CADCII ICADC
• David Greb, M.D.
• Greg Carlson, DDS, Inc (Valley Center Smiles)
• Erica Danielle Harris, DDS
• Angelica Maria Heredia, ACSWS

• Marriage & Family Therapist in Valley Center, CA
• Providers in Valley Center, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.