Healthcare Provider Details

I. General information

NPI: 1063959674
Provider Name (Legal Business Name): JOSH WESTON LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/21/2017
Last Update Date: 05/03/2026
Certification Date: 05/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

912 MARGUERITA AVE
SANTA MONICA CA
90402-2030
US

IV. Provider business mailing address

19201 ENTRADERO AVE
TORRANCE CA
90503-1302
US

V. Phone/Fax

Practice location:
  • Phone: 310-999-1131
  • Fax:
Mailing address:
  • Phone: 310-999-1131
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number109808
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: