Provider Demographics
NPI:1730494014
Name:THE WESTWOOD PSYCHOTHERAPY PRACTICE, INC.
Entity Type:Organization
Organization Name:THE WESTWOOD PSYCHOTHERAPY PRACTICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:310-824-2076
Mailing Address - Street 1:10845 LINDBROOK DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90024-3042
Mailing Address - Country:US
Mailing Address - Phone:310-824-2076
Mailing Address - Fax:323-653-1211
Practice Address - Street 1:10845 LINDBROOK DR
Practice Address - Street 2:SUITE 201
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90024-3042
Practice Address - Country:US
Practice Address - Phone:310-824-2076
Practice Address - Fax:323-653-1211
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-11
Last Update Date:2010-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY8919103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CP8919Medicare UPIN