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General NPI Number Information
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NPI Number | 1043313620
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Entity Type | Individual
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Provider Name | NORMAN D REICHWALD PSYD
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Gender | Male
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Dates
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Enumeration Date | 09/07/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1206 E 17TH STREET SUITE 106
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City | SANTA ANA
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State | CA
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Zip | 92701-2641
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Country | US
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Telephone | 714-210-8848
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Fax | 714-210-8856
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Provider Business Mailing Address
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Address Line | 3250 WILSHIRE BLVD SUITE 930
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City | LOS ANGELES
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State | CA
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Zip | 90010-1438
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Country | US
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Telephone | 213-739-0019
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Fax | 213-739-0091
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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 | PSY19287
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License Number State | CA
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