Provider Demographics
NPI:1730562984
Name:NEMIROFF-POLUTANOVICH, PAULA (LMFT)
Entity type:Individual
Prefix:MS
First Name:PAULA
Middle Name:
Last Name:NEMIROFF-POLUTANOVICH
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4212 E LOS ANGELES AVE # 4074
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93063-3308
Mailing Address - Country:US
Mailing Address - Phone:805-558-6457
Mailing Address - Fax:805-584-6457
Practice Address - Street 1:1541 WILSHIRE BLVD # 300
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90017-2211
Practice Address - Country:US
Practice Address - Phone:213-955-9090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-07
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program