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General NPI Number Information
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NPI Number | 1700850278
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Entity Type | Individual
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Provider Name | VALERIE WITHERSPOON PHD, RN, CS
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Gender | Female
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Dates
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Enumeration Date | 02/13/2006
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Last Update Date | 11/09/2007
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Provider Practice Location Address
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Address Line | 5000 OVERLAND AVE 8
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City | CULVER CITY
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State | CA
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Zip | 90230-4995
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Country | US
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Telephone | 310-838-2738
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Fax | 310-838-2729
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Provider Business Mailing Address
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Address Line | 5000 OVERLAND AVE 8
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City | CULVER CITY
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State | CA
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Zip | 90230-4995
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Country | US
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Telephone | 310-838-2738
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Fax | 310-838-2729
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSY13838
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 364SP0808X
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Taxonomy Name | Psychiatric/Mental Health Clinical Nurse Specialist
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License Number | 319821
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License Number State | CA
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