MEDICARE: M JODY WHITEHOUSE MD, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician

General Provider Information

NPI Number	:	1285587600
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	M JODY WHITEHOUSE MD, INC

Provider Business Mailing Address
First Line	:	1510 S POINT VIEW ST
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90035-3912
Country	:	US
Telephone Number	:	213-545-1257
Fax Number	:	310-974-4972

Provider Business Practice Location Address
First Line	:	1510 S POINT VIEW ST
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90035-3912
Country	:	US
Telephone Number	:	213-545-1257
Fax Number	:	310-974-4972

Authorized Official
Title or Position	:	BILLER
Name	:	EILEEN MARY GRAHAM
Credential	:
Telephone Number	:	949-324-3433

Provider Enumeration Date	:	02/16/2026
Last Update Date	:	02/16/2026

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