Individual
NATHANIEL VAN GOODLOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
433 CALLAN AVE, SUITE 307, SAN LEANDRO, CA 94577-4643
(510) 310-6994
Mailing address
433 CALLAN AVE, SUITE 307, SAN LEANDRO, CA 94577-4643
Taxonomy
Speciality
Code
Description
License number
State
103TP0016X
Prescribing (Medical) Psychologist
Primary
PSY14990
CA
Other
Enumeration date
05/22/2007
Last updated
07/09/2007
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