Healthcare Provider Details
I. General information
NPI: 1962581900
Provider Name (Legal Business Name): KIM THI NGUYEN PIERCE PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 11/02/2006
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3501 SEPULVEDA BLVD FL 5
TORRANCE CA
90505-2537
US
IV. Provider business mailing address
PO BOX 3295
REDONDO BEACH CA
90277-1295
US
V. Phone/Fax
- Phone: 310-668-6851
- Fax: 310-898-1607
- Phone: 310-668-6851
- Fax: 310-898-1607
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC2200X |
| Taxonomy | Clinical Child & Adolescent Psychologist |
| License Number | PSY 17774 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: