Provider Demographics
NPI:1760794283
Name:MALAMED, BETH MICHELE (MA)
Entity Type:Individual
Prefix:MS
First Name:BETH
Middle Name:MICHELE
Last Name:MALAMED
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MS
Other - First Name:ELIZABETH
Other - Middle Name:MICHELE
Other - Last Name:MALAMED
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA
Mailing Address - Street 1:5013 NEWCASTLE AVE
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316-3510
Mailing Address - Country:US
Mailing Address - Phone:310-709-4504
Mailing Address - Fax:310-709-4504
Practice Address - Street 1:5013 NEWCASTLE AVE
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316-3510
Practice Address - Country:US
Practice Address - Phone:310-709-4504
Practice Address - Fax:310-709-4504
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-13
Last Update Date:2022-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA42490106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist