Healthcare Provider Details

I. General information

NPI: 1669254553
Provider Name (Legal Business Name): NADINE M BOUZ PSYD, LP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/16/2023
Last Update Date: 07/23/2025
Certification Date: 07/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

675 W FOOTHILL BLVD STE 200
CLAREMONT CA
91711-3475
US

IV. Provider business mailing address

675 W FOOTHILL BLVD STE 200
CLAREMONT CA
91711-3475
US

V. Phone/Fax

Practice location:
  • Phone: 925-282-1778
  • Fax: 415-296-5299
Mailing address:
  • Phone: 925-282-1778
  • Fax: 415-296-5299

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number35772
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: