Provider Demographics
NPI:1114916707
Name:BEWS, JAMES EDWARD (PHD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:EDWARD
Last Name:BEWS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:10817 SANTA MONICA BLVD
Mailing Address - Street 2:100
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-4690
Mailing Address - Country:US
Mailing Address - Phone:310-828-7146
Mailing Address - Fax:310-439-1130
Practice Address - Street 1:10817 SANTA MONICA BLVD
Practice Address - Street 2:100
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-4655
Practice Address - Country:US
Practice Address - Phone:310-828-7146
Practice Address - Fax:310-439-1130
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-17
Last Update Date:2010-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY3831103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CY580BMedicare PIN