Active NPI
Elisha Goldstein, PH.D.
- Psychologist
- Los Angeles, CA
National Provider Identifier
1396997383
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 21779
- Practice address
- 10825 Ashby Ave
Los Angeles, CA 90064-3212 - Phone
- (310) 597-9276
- NPI assigned
- Oct 21, 2008
- Last updated
- Oct 21, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 21779 | CA | Primary |
Addresses
Primary practice location
10825 Ashby Ave
Los Angeles, CA 90064-3212
Mailing address
10825 Ashby Ave
Los Angeles, CA 90064-3212
Phone (310) 597-9276
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21779 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1224547200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1224547200000",
"number": "1396997383",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10825 ASHBY AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900643212",
"telephone_number": "310-597-9276"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10825 ASHBY AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900643212",
"telephone_number": "310-597-9276"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDSTEIN",
"first_name": "ELISHA",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-10-21",
"last_updated": "2008-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "21779",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.