Healthcare Provider Details

I. General information

NPI: 1821128026
Provider Name (Legal Business Name): DAVID MARK HURWITZ LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/06/2007
Last Update Date: 12/20/2019
Certification Date: 12/20/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5743 CORSA AVE STE 221
WESTLAKE VILLAGE CA
91362-6451
US

IV. Provider business mailing address

5743 CORSA AVE STE 221
WESTLAKE VILLAGE CA
91362-6451
US

V. Phone/Fax

Practice location:
  • Phone: 818-754-8625
  • Fax:
Mailing address:
  • Phone: 818-754-8625
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFC43515
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: