Provider Demographics
NPI:1093879488
Name:LIVINGSTON, DAVID B (MFT)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:B
Last Name:LIVINGSTON
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 S BEVERLY DR
Mailing Address - Street 2:SUITE 412
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212-4808
Mailing Address - Country:US
Mailing Address - Phone:310-285-8896
Mailing Address - Fax:818-225-7547
Practice Address - Street 1:250 N ROBERTSON BLVD
Practice Address - Street 2:SUITE 407
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-1788
Practice Address - Country:US
Practice Address - Phone:310-285-8896
Practice Address - Fax:818-225-7547
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-20
Last Update Date:2008-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35434106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA35434OtherMFT