Provider Demographics
NPI:1487782298
Name:LANDEN, JAMES EDWARD (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:EDWARD
Last Name:LANDEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:370 N WESTLAKE BLVD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91362-7041
Mailing Address - Country:US
Mailing Address - Phone:805-496-1506
Mailing Address - Fax:805-496-4186
Practice Address - Street 1:370 N WESTLAKE BLVD
Practice Address - Street 2:SUITE 220
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91362-7041
Practice Address - Country:US
Practice Address - Phone:805-496-1506
Practice Address - Fax:805-496-4186
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2012-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG517782084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
2084P0800XMedicare PIN
CAA93108Medicare UPIN
CAG51778Medicare ID - Type Unspecified