Provider Demographics
NPI:1720519549
Name:WESTSIDE DBT, INC
Entity Type:Organization
Organization Name:WESTSIDE DBT, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:SASHA
Authorized Official - Middle Name:
Authorized Official - Last Name:GINSBURG
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:310-625-6981
Mailing Address - Street 1:11340 W OLYMPIC BLVD
Mailing Address - Street 2:STE 307
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90064
Mailing Address - Country:US
Mailing Address - Phone:310-625-6981
Mailing Address - Fax:
Practice Address - Street 1:11340 W OLYMPIC BLVD
Practice Address - Street 2:STE 307
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90064
Practice Address - Country:US
Practice Address - Phone:310-625-6981
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WESTSIDE DBT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-03-23
Last Update Date:2017-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA299591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty