1417086224 NPI number — JULIE REBECCA-ALPERT WEINSTEIN LCSW

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1417086224 NPI number — JULIE REBECCA-ALPERT WEINSTEIN LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WEINSTEIN
Provider First Name:
JULIE
Provider Middle Name:
REBECCA-ALPERT
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ALPERT
Provider Other First Name:
JULIE
Provider Other Middle Name:
REBECCA
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1417086224
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/07/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
12821 VICTORY BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORTH HOLLYWOOD
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91606-3012
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
818-432-5025
Provider Business Mailing Address Fax Number:
818-760-9092

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12821 VICTORY BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORTH HOLLYWOOD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91606-3012
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-432-5025
Provider Business Practice Location Address Fax Number:
818-760-9092
Provider Enumeration Date:
03/05/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  LCS 25682 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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