Healthcare Provider Details

I. General information

NPI: 1225251069
Provider Name (Legal Business Name): SUSAN BELZ HURWICH PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/10/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3625 E THOUSAND OAKS BLVD SUITE 275
WESTLAKE VILLAGE CA
91362-3626
US

IV. Provider business mailing address

16 W SIDLEE ST
THOUSAND OAKS CA
91360-3240
US

V. Phone/Fax

Practice location:
  • Phone: 805-497-0665
  • Fax: 805-494-1112
Mailing address:
  • Phone: 805-494-0982
  • Fax: 805-494-1112

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFC19298
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: