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General NPI Number Information
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NPI Number | 1649036898
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Entity Type | Individual
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Provider Name | CODY MATTHEW WESTON
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Gender | Male
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Dates
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Enumeration Date | 02/26/2024
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Last Update Date | 02/26/2024
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Provider Practice Location Address
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Address Line | 388 S LOS ROBLES AVE
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City | PASADENA
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State | CA
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Zip | 91101-3841
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Country | US
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Telephone | 626-737-4335
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Fax |
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Provider Business Mailing Address
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Address Line | 417 MONROVISTA AVE UNIT A
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City | MONROVIA
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State | CA
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Zip | 91016-4633
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Country | US
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Telephone | 904-657-7109
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 15238
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 142985
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License Number State | CA
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