1104066026 NPI number — DR. NORA NAIM PSYD

Table of content: DR. NORA NAIM PSYD (NPI 1104066026)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1104066026 NPI number — DR. NORA NAIM PSYD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NAIM
Provider First Name:
NORA
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PSYD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
TAYLOR
Provider Other First Name:
NORA
Provider Other Middle Name:
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
PSYD
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1104066026
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/17/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1820 S CATALINA AVE STE 105
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
REDONDO BEACH
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90277-5511
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
424-262-3512
Provider Business Mailing Address Fax Number:
424-267-0150

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1820 S CATALINA AVE STE 105
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
REDONDO BEACH
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90277-5511
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
424-262-3512
Provider Business Practice Location Address Fax Number:
424-267-0150
Provider Enumeration Date:
03/05/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103TF0000X , with the licence number:  PSY27442 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TA0400X , with the licence number: PSY27442 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TP0814X , with the licence number: PSY27442 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TC0700X , with the licence number: PSY27442 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)