Provider Demographics
NPI:1497091045
Name:LEARNING DYNAMICS, INC.
Entity Type:Organization
Organization Name:LEARNING DYNAMICS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:310-855-3276
Mailing Address - Street 1:22837 VENTURA BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-1224
Mailing Address - Country:US
Mailing Address - Phone:310-855-3276
Mailing Address - Fax:310-393-9893
Practice Address - Street 1:22837 VENTURA BLVD
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-1224
Practice Address - Country:US
Practice Address - Phone:310-855-3276
Practice Address - Fax:310-393-9893
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-28
Last Update Date:2019-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251V00000XAgenciesVoluntary or Charitable
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACA178403OtherMEDICARE PTAN
CAGX727AOtherMEDICARE PTAN