Healthcare Provider Details

I. General information

NPI: 1386761492
Provider Name (Legal Business Name): WESTON JOSHU TAUSSIG MFT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/23/2007
Last Update Date: 02/29/2024
Certification Date: 02/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 S FAIR OAKS AVE STE 300
PASADENA CA
91105-2672
US

IV. Provider business mailing address

2055 BARNETT WAY
LOS ANGELES CA
90032-4105
US

V. Phone/Fax

Practice location:
  • Phone: 626-441-4221
  • Fax: 626-441-6479
Mailing address:
  • Phone: 213-924-3436
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number44083
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: