Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | PSY 6722 | CA |
Y | 103TC0700X | Clinical Psychologist | PSY 6722 | CA |
NPI | 1013115971 |
---|---|
Provider Name | Marc Lawrence Levitt |
First Address | Manhattan Beach, CA 90266-7253 |
Second Address | Los Angeles, CA 90064-1524 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2007 |
Last Update Date | 08/07/2007 |