Provider Demographics
NPI:1588487284
Name:MITCHELL, TUWESHA (PPS)
Entity type:Individual
Prefix:
First Name:TUWESHA
Middle Name:
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:PPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23150 AVENUE SAN LUIS APT 209
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-1037
Mailing Address - Country:US
Mailing Address - Phone:909-648-6821
Mailing Address - Fax:
Practice Address - Street 1:23150 AVENUE SAN LUIS APT 209
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-1037
Practice Address - Country:US
Practice Address - Phone:909-648-6821
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-02
Last Update Date:2024-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool