Healthcare Provider Details

I. General information

NPI: 1114916707
Provider Name (Legal Business Name): JAMES EDWARD BEWS PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/17/2005
Last Update Date: 09/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10817 SANTA MONICA BLVD 100
LOS ANGELES CA
90025-4655
US

IV. Provider business mailing address

10817 SANTA MONICA BLVD 100
LOS ANGELES CA
90025-4690
US

V. Phone/Fax

Practice location:
  • Phone: 310-828-7146
  • Fax: 310-439-1130
Mailing address:
  • Phone: 310-828-7146
  • Fax: 310-439-1130

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY3831
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: