1144320607 NPI number — MS. NAOMI RUTH RESNIK LCSW, LMFT

Table of content: MS. NAOMI RUTH RESNIK LCSW, LMFT (NPI 1144320607)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144320607 NPI number — MS. NAOMI RUTH RESNIK LCSW, LMFT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RESNIK
Provider First Name:
NAOMI
Provider Middle Name:
RUTH
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LCSW, LMFT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
RESNIK SKULSKY
Provider Other First Name:
NAOMI
Provider Other Middle Name:
RUTH
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1144320607
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2200 PACIFIC COAST HWY
Provider Second Line Business Mailing Address:
SUITE 208
Provider Business Mailing Address City Name:
HERMOSA BEACH
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90254
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
310-372-8887
Provider Business Mailing Address Fax Number:
310-821-3724

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2200 PACIFIC COAST HWY
Provider Second Line Business Practice Location Address:
SUITE 208
Provider Business Practice Location Address City Name:
HERMOSA BEACH
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90254
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-372-8887
Provider Business Practice Location Address Fax Number:
310-821-3724
Provider Enumeration Date:
09/25/2006

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: 1041C0700X , with the licence number:  5304 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 106H00000X , with the licence number: 9058 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

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