Provider Demographics
NPI:1447346986
Name:WHITNEY, JONIBETH (PHD)
Entity type:Individual
Prefix:DR
First Name:JONIBETH
Middle Name:
Last Name:WHITNEY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1328 WESTWOOD BLVD
Mailing Address - Street 2:STE 24
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90024-4931
Mailing Address - Country:US
Mailing Address - Phone:310-446-8870
Mailing Address - Fax:310-446-8078
Practice Address - Street 1:1328 WESTWOOD BLVD
Practice Address - Street 2:STE 24
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90024-4931
Practice Address - Country:US
Practice Address - Phone:310-446-8870
Practice Address - Fax:310-446-8078
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY20238103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACP20238Medicare ID - Type Unspecified