Individual
DAVID GOTTLIEB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
731 CINDY LN, PETALUMA, CA 94952-2060
(510) 421-1496
Mailing address
731 CINDY LN, PETALUMA, CA 94952-2060
(510) 421-1496
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
35125
CA
101YM0800X
Mental Health Counselor
—
—
101YS0200X
School Counselor
—
—
Other
Enumeration date
01/08/2021
Last updated
01/08/2021
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