Healthcare Provider Details

I. General information

NPI: 1104066026
Provider Name (Legal Business Name): NORA NAIM PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NORA TAYLOR PSYD

II. Dates (important events)

Enumeration Date: 03/05/2009
Last Update Date: 09/17/2022
Certification Date: 09/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1820 S CATALINA AVE STE 105
REDONDO BEACH CA
90277-5511
US

IV. Provider business mailing address

1820 S CATALINA AVE STE 105
REDONDO BEACH CA
90277-5511
US

V. Phone/Fax

Practice location:
  • Phone: 424-262-3512
  • Fax: 424-267-0150
Mailing address:
  • Phone: 424-262-3512
  • Fax: 424-267-0150

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License NumberPSY27442
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License NumberPSY27442
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code103TP0814X
TaxonomyPsychoanalysis Psychologist
License NumberPSY27442
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY27442
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: