Healthcare Provider Details

I. General information

NPI: 1033443247
Provider Name (Legal Business Name): JOANNE S NEWFIELD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2009
Last Update Date: 02/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1721 GRIFFIN AVE
LOS ANGELES CA
90031-3312
US

IV. Provider business mailing address

3706 STONE CANYON AVE
SHERMAN OAKS CA
91403-4531
US

V. Phone/Fax

Practice location:
  • Phone: 323-221-4134
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number52240
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number59729
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: