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General NPI Number Information
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NPI Number | 1548049588
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Entity Type | Organization
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Legal Business Name | NECTAR REDMAN PSY.D., A PSYCHOLOGICAL CORPORATION
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Dates
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Enumeration Date | 09/28/2023
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Last Update Date | 09/28/2023
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Provider Practice Location Address
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Address Line | 11022 SANTA MONICA BLVD STE 370
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City | LOS ANGELES
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State | CA
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Zip | 90025-7532
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Country | US
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Telephone | 310-773-1919
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Fax |
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Provider Business Mailing Address
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Address Line | 11022 SANTA MONICA BLVD STE 370
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City | LOS ANGELES
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State | CA
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Zip | 90025-7532
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Country | US
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Telephone | 310-710-7503
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | NECTAR RACHEL REDMAN
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Credential | PSY.D.
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Telephone | 310-773-1919
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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 |
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License Number State |
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