Provider Demographics
NPI:1649299355
Name:WALDMAN, BARBARA ELLEN (MA, LCSW, PHD)
Entity type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:ELLEN
Last Name:WALDMAN
Suffix:
Gender:F
Credentials:MA, LCSW, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1313 FOOTHILL BLVD STE 9
Mailing Address - Street 2:
Mailing Address - City:LA CANADA
Mailing Address - State:CA
Mailing Address - Zip Code:91011-2163
Mailing Address - Country:US
Mailing Address - Phone:818-790-9543
Mailing Address - Fax:
Practice Address - Street 1:1313 FOOTHILL BLVD STE 9
Practice Address - Street 2:
Practice Address - City:LA CANADA
Practice Address - State:CA
Practice Address - Zip Code:91011-2163
Practice Address - Country:US
Practice Address - Phone:818-790-9543
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ355911041C0700X
CA71191041C0700X
CA8512106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist