Provider Demographics
NPI:1598092686
Name:LANDSMAN, ERIN (MA)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:LANDSMAN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3086 BLACK HILLS CT
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91362-3513
Mailing Address - Country:US
Mailing Address - Phone:310-991-5535
Mailing Address - Fax:
Practice Address - Street 1:3062 BLACK HILLS CT
Practice Address - Street 2:
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91362-3513
Practice Address - Country:US
Practice Address - Phone:310-991-5535
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-10
Last Update Date:2017-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA42470106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1309161Medicaid