Provider Demographics
NPI:1164103560
Name:WHIDDEN, PAULA
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:
Last Name:WHIDDEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18565 SOLEDAD CANYON RD # 270
Mailing Address - Street 2:
Mailing Address - City:CANYON COUNTRY
Mailing Address - State:CA
Mailing Address - Zip Code:91351-3700
Mailing Address - Country:US
Mailing Address - Phone:661-347-6644
Mailing Address - Fax:
Practice Address - Street 1:6303 OWENSMOUTH AVE STE 1065A
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91367-2264
Practice Address - Country:US
Practice Address - Phone:800-273-8255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-27
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAMFT138957106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist