Provider Demographics
NPI:1912246992
Name:MCMAHON, JUDITH C (LCSW)
Entity type:Individual
Prefix:
First Name:JUDITH
Middle Name:C
Last Name:MCMAHON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:JUDITH
Other - Middle Name:C
Other - Last Name:HOROWITZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:3307 SHERI DR
Mailing Address - Street 2:APT D
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93063-7132
Mailing Address - Country:US
Mailing Address - Phone:805-928-4848
Mailing Address - Fax:
Practice Address - Street 1:4545 INDUSTRIAL ST
Practice Address - Street 2:SUITE 5L
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93063-7132
Practice Address - Country:US
Practice Address - Phone:805-328-4848
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-11
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0749761104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker