Provider Demographics
NPI:1437233053
Name:WEITHORN, HOWARD B (PSYCHOLOGIST)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:B
Last Name:WEITHORN
Suffix:
Gender:M
Credentials:PSYCHOLOGIST
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Other - First Name:
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Mailing Address - Street 1:321 S BEVERLY DR
Mailing Address - Street 2:SUITE 'T'
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212-4303
Mailing Address - Country:US
Mailing Address - Phone:310-277-7477
Mailing Address - Fax:818-788-5911
Practice Address - Street 1:321 S BEVERLY DR
Practice Address - Street 2:SUITE 'T'
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-4303
Practice Address - Country:US
Practice Address - Phone:310-277-7477
Practice Address - Fax:818-788-5911
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAPSY 4640103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist