Provider Demographics
NPI:1225271240
Name:NATE NEWMAN PH D BCD LCSW PC
Entity Type:Organization
Organization Name:NATE NEWMAN PH D BCD LCSW PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NATE
Authorized Official - Middle Name:
Authorized Official - Last Name:NEWMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:818-596-2069
Mailing Address - Street 1:4055 THOUSAND OAKS BLVD
Mailing Address - Street 2:SUITE 215
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91362-3600
Mailing Address - Country:US
Mailing Address - Phone:818-596-2069
Mailing Address - Fax:818-225-9755
Practice Address - Street 1:4055 THOUSAND OAKS BLVD
Practice Address - Street 2:SUITE 215
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91362-3600
Practice Address - Country:US
Practice Address - Phone:818-596-2069
Practice Address - Fax:818-225-9755
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-07
Last Update Date:2010-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS10217251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health