Provider Demographics
NPI:1235122607
Name:SILVERMAN, BONNIE ZIVETZ (LCSW)
Entity Type:Individual
Prefix:
First Name:BONNIE
Middle Name:ZIVETZ
Last Name:SILVERMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12301 WILSHIRE BLVD STE 416
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-1051
Mailing Address - Country:US
Mailing Address - Phone:310-560-5840
Mailing Address - Fax:310-839-1507
Practice Address - Street 1:12301 WILSHIRE BLVD
Practice Address - Street 2:STE 416
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-1007
Practice Address - Country:US
Practice Address - Phone:310-826-8284
Practice Address - Fax:310-839-1507
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-31
Last Update Date:2010-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS12086101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASW12086Medicare ID - Type Unspecified