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General NPI Number Information
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NPI Number | 1255740684
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Entity Type | Individual
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Provider Name | JAMES MCNINCH LCSW
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Gender | Male
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Dates
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Enumeration Date | 08/11/2014
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Last Update Date | 10/22/2024
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Provider Practice Location Address
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Address Line | 31324 VIA COLINAS STE 108
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City | WESTLAKE VILLAGE
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State | CA
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Zip | 91362-6756
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Country | US
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Telephone | 310-292-8337
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Fax |
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Provider Business Mailing Address
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Address Line | 1328 2ND ST
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City | SANTA MONICA
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State | CA
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Zip | 90401-1122
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 115719
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License Number State | CA
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