Healthcare Provider Details

I. General information

NPI: 1811802556
Provider Name (Legal Business Name): REMY RAYMOND PMHNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3030 W OLYMPIC BLVD STE 217
LOS ANGELES CA
90006-6507
US

IV. Provider business mailing address

3030 W OLYMPIC BLVD STE 217
LOS ANGELES CA
90006-6507
US

V. Phone/Fax

Practice location:
  • Phone: 213-550-2159
  • Fax:
Mailing address:
  • Phone: 213-550-2159
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95040841
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: