MEDICARE: DR. NATE NEWMAN PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	LCS10217	CA

General Provider Information

NPI Number	:	1558359331
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NATE NEWMAN PH.D.

Provider Business Mailing Address
First Line	:	4055 THOUSAND OAKS BLVD
Second Line	:	SUITE 215
City	:	WESTLAKE VILLAGE
State	:	CA
Zip	:	91362-3600
Country	:	US
Telephone Number	:	818-596-2069
Fax Number	:	818-225-9755

Provider Business Practice Location Address
First Line	:	4055 THOUSAND OAKS BLVD
Second Line	:	SUITE 215
City	:	WESTLAKE VILLAGE
State	:	CA
Zip	:	91362-3600
Country	:	US
Telephone Number	:	818-596-2069
Fax Number	:	818-225-9755

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/06/2005
Last Update Date	:	07/08/2007

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