Provider Demographics
NPI:1558669143
Name:LITWIN, LINDA MILES (PHD)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:MILES
Last Name:LITWIN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19634 VENTURA BLVD
Mailing Address - Street 2:SUITE 325
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-2966
Mailing Address - Country:US
Mailing Address - Phone:818-292-9312
Mailing Address - Fax:
Practice Address - Street 1:19634 VENTURA BLVD
Practice Address - Street 2:SUITE 325
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-2966
Practice Address - Country:US
Practice Address - Phone:818-292-9312
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-04
Last Update Date:2011-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 6724103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist