Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | LCS18330 | CA |
NPI | 1003068842 |
---|---|
Provider Name | Paul Howard Levine |
First Address | Castaic, CA 91384-2905 |
Second Address | Castaic, CA 91384-2905 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/10/2008 |
Last Update Date | 10/10/2008 |