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General NPI Number Information
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NPI Number | 1023042082
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Entity Type | Individual
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Provider Name | NOURIT H KORZENNIK PH D
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Gender | Female
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Dates
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Enumeration Date | 07/10/2006
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Last Update Date | 12/14/2016
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Provider Practice Location Address
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Address Line | 24050 MADISON ST SUITE 100-C
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City | TORRANCE
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State | CA
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Zip | 90505-6015
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Country | US
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Telephone | 310-378-7333
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Fax |
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Provider Business Mailing Address
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Address Line | 24050 MADISON ST STE 100C
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City | TORRANCE
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State | CA
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Zip | 90505-6080
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Country | US
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Telephone | 310-378-7333
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Fax | 310-378-7291
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSY 15745
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License Number State | CA
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